Here is the text we could read:
RIGHT / LEFT
THUMB / FINGER
PRINT
Violation Date: (Day of Week) / / Time: (AM/PM) Case No.:
Name:(First, Middle, Last)/(Company)
Owner’s Responsibility: (Y/N) (VC 40001)
Address:
City: State/Country: ZIP:
Juvenile (Phone #): ( ) E-mail Address:
Driver Lic.: (No.) State/Country:
Birth Date: / / Age: Juvenile: (Y/N)
Sex: Hair: Eyes: Ht: Wt: Race: Other Descr.:
Veh. Lic. or VIN: (No.)
State/Country:
Class:
Reg.: (Mo/Yr) Exp
Comm. Lic.: (Y/N)
Yr. of Veh.:
Make:
Model:
Body Style: Color:
COMMERCIAL VEH. (VC 15210(b)): (Y/N) HAZ. MAT. (VC 353): (Y/N)
Evid. of Financial Resp.: CHP/DOT/PUC/ICC
Registered Owner or Lessee: (First, Middle, Last/Company)
Address:
City: State/Country: ZIP:
Veh. 2: Veh. Lic. or VIN: (No.) State/Country: Reg.: (Mo/Yr) Exp
Yr. of Veh.: Make: Model: Body Style: Color:
Veh. 3: Veh. Lic. or VIN: (No.) State/Country: Reg.: (Mo/Yr) Exp
Yr. of Veh.: Make: Model: Body Style: Color:
Veh. 4: Veh. Lic. or VIN: (No.) State/Country: Reg.: (Mo/Yr) Exp
Yr. of Veh.: Make: Model: Body Style: Color:
Construction-VC 42009 (Y/N) Safety Zone-VC 42010 (Y/N) School Zone (Y/N)
Correctable Booking Required: (Y/N) (see reverse)
Violation (VC 40610)
(Yes/No) Code Section Description Overweight Misd./ Infrac.
(Y/N)
(Y/N)
(Y/N)
(Y/N)
(Y/N)
(Y/N)
Llbs (M/I)
lbs (M/I)
lbs (M/I)
lbs (M/I)
lbs (M/I)
lbs (M/I)
Speed Approx: P.F./Max Spd.: Veh. Lmt.: Safe: Radar: (Y/N)
Location of Violation(s) at: (City/County of Occurrence)
Conditions: (Weather, Road & Traffic Conditions, Etc.)
NOTICE TO APPEA R Citation: (No.)
Misdemeanor: (Y/N) Traffic: (Y/N) Nontraffic: (Y/N)
gency: (Name and Jurisdiction)
A
emarks:
ccident (Y/N)
WITHOUT ADMITTING GUILT, I PROMISE TO APPEAR AT THE
TIME AND PLACE INDICATED BELOW.
Signature
X
WHEN: ON OR BEFORE THIS DATE: __/___/_____ Time: (AM/PM)
WHAT TO DO: FOLLOW THE INSTRUCTIONS ON THE REVERSE.
PHOTO
WHERE: BEFORE A JUDGE OR CLERK OF THE
(Name of court[s])
(Section[s] or division[s], room no[s].)
(Street address[es])
(Phone No.)
To be notified (Y/N) Contact the clerk to appear at a night court session: (Y/N)
Violations not committed in my presence, declared on information or
belief.
declare under penalty of perjury under the laws of the State of California the
foregoing is true and correct.
Executed at: (Place) Violation Location:
____(Signature)__________ _ _ /_ / __
Arresting or Citing Officer Declaration Date
_____(Name)____ ______ _ _ /_ / __
Arresting Officer, Declaration Date
if different from Citing Officer:
erial / ID: _____________ Dates Off: / / to _/ /____
Judicial Council of California Form
New 06-26-15 (VC 40500(b), 40513(b),
40522, and 40600; PC 853.9 and
959.1) TR-145 DEFENDANT COPY
FPO Barcode
USS Code 39
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ELECTRONIC TRAFFIC/NONTRAFFIC NOTICE TO APPEAR (Defendant’s Copy)
Shaded areas indicate spaces subject to violation details or modification for local or agency requirements.
LOCAL
AVAILABLE ONLINE AT [website address]
INFORMATION FOR THE CITATION
IS
IMPORTANT — READ CAREFULLY
WARNING: If you fail to appear in court as you have promised,
you may be arrested and punished by 6 MONTHS IN JAIL
AND/OR A $1,000 FINE regardless of the disposition of the
original charge. (Veh. Code, § 40508 or Pen. Code, § 853.7.) In
addition, any person who fails to appear as provided by law may
be deemed to have elected to have a trial by written declaration
(in absentia) pursuant to Vehicle Code section 40903(a) upon
any alleged infraction, as charged by the arresting/citing officer.
JUVENILE: If you were under age 18 at the time the citation was
issued, you must appear in court with your parent or guardian.
COURTESY NOTICE: A courtesy notice may be mailed to the
address shown on your citation, indicating the required deposit of
money (bail) that may be forfeited instead of your appearing in court.
If you do not receive such courtesy notice, you are still required to
comply with the items below by the appearance date.
WHAT TO DO
You are required to appear at court for a misdemeanor violation. For
all violations, your court date/time/place are provided above in this
notice to appear. Have the citation with you when contacting the
court. In all infraction cases, you must do one or more of the
following for each violation:
Pay the fine (bail). Correct the violation (traffic cases,
when applicable).
Appear in court. Request traffic school (traffic cases,
when applicable).
Contest the violation. Request trial by written declaration
(traffic cases).
If you do not do one of the above actions, then a “failure to appear”
charge will be filed against you (Veh. Code, § 40508(a)) and your
driver license may be withheld, suspended, or revoked. In some
courts you may be charged an amount in addition to the bail amount
and the case may be turned over to a collection agency.
(Pen. Code, § 1214.1.)
. If you do NOT contest the violation:
1
a. (Pay the bail amount) Contact the court for bail information.
You will not have to appear in court. You will be convicted of the
violation, and it will appear on your record at the Department of Motor
Vehicles (DMV). A point count may be charged to your DMV record
and your insurance may be adversely affected.
. (Traffic school) You may be able to avoid the point count by
completing traffic school. You must pay the bail amount as a fee,
and you may have to pay other fees. Contact the court to request
traffic school.
. (Correctable violations) If the “Yes” box is checked above, the
violation is correctable. Upon correction of the violation, have a law
enforcement officer or an authorized inspection/installation station
agent sign below. (Veh. Code, § 40616.) Registration and driver
license violations may also be certified as corrected at an office of
the DMV or by any clerk or deputy clerk of a court. The violation will
be dismissed by the court after PROOF OF CORRECTION and
payment of a transaction fee are presented to the court by mail or in
person by the appearance date. Violations of Vehicle Code section
16028 (automobile liability insurance) will be dismissed only upon (1)
your showing or mailing to the court evidence of financial
responsibility valid at the time this notice to appear was issued, and
(2) your payment of a transaction fee.
b
c
CERTIFICATE OF CORRECTION
(MUST BE RETURNED TO COURT)
Section
Violated
Signature
Certifying
Correction
Serial/
ID No.
Agency
Date
2. If you contest the violation (select a or b):
a. (Court trial) Send a certified or registered letter postmarked
not later than five days prior to the appearance date or come to the
court by the appearance date to request a court trial on a future date
when an officer and any witnesses will be present. You may be
required to submit the bail amount. Go online or call the court
for information on going to court without paying bail.—OR—
b. (Trial by written declaration (traffic infractions)) Send a
certified or registered letter postmarked not later than five days prior
to the appearance date or come to the court on or before the
appearance date to request a trial by written declaration. Submit the
bail amount. You will be given forms to allow you to write a
statement and to submit other evidence without appearing in court.
An officer will also submit a statement. The judicial officer will
consider the evidence and decide the case.
3 Make check/money order payable to Clerk of the Court. Write
your citation number and driver license number on your check or
money order. You may pay in person, by mail, or by phone.
4. If “Booking Required” is checked you must appear for booking
on a weekday prior to your court date at _____________________
between the hours of________ and _______ and bring the signed
verification to your court appearance.
Call _________________ for more information.
Booking Verification: I declare under penalty
of perjury under the laws of the State of
alifornia that _ (Defendant’s Name)___
was booked on ___ (Date)__________
fficer: ____________________________
erial / ID No.: ______________________
(L/ R) THUMB/
FINGER PRINT
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ELECTRONIC TRAFFIC/NONTRAFFIC NOTICE TO APPEAR (Defendant’s Instructions)
Shaded areas indicate spaces subject to modification for local or agency requirements.
