TRAFFIC TICKET INFORMATION SHEET
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FIRST NAME:
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LAST NAME:
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PHONE NUMBER
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DATE OF BIRTH
MM
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DD
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YYYY
DRIVERS LICENSE NUMBER
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LAST 4 DIGITS OF SOCIAL SECURITY NUMBER
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MAILING ADDRESS (INCLUDE APT NUMBER, CITY, STATE & ZIP CODE)
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EMERGENCY CONTACT NAME & PHONE NUMBER
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LOCATIONS OF YOUR CITATIONS/WARRANTS
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Citations Numbers & Violations
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DO YOU HAVE ANY INFORMATION TO ASSIST IN YOUR DEFENSE (i.e. current ID, renewed registration, was not speeding)
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