Application for Community Court Debt Funds
We need this information so that we can send a check to the right location.
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Date of request
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What is your legal name? *
What is your date of birth? *
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What is your phone number? *
Is it restitution, home confinement, probation, fines and fees, etc?
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What courthouse/office should we make the check out to? *
What is the case number for the check memo?  *
Do you have a monthly payment plan set up for any of your cases? How much is your monthly payment? *
Do you have a warrant for a missed payment? *
Do you have an upcoming court date to make a payment? *
Are you aware that you can request a reduction in court fees and fines? *
Are you probation?  *
If you are on probation, have you completed all requirements and finished your sentence, except for restitution payments? (You may be eligible to stop restitution payments and be taken off probation.)
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Is there anything else we should know that makes your case urgent?
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