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2. 

   7105 Whitley Road, Watauga, Texas 76148 817.514.5715
4. First Name*
5. Last Name*
7. Address1*
9. Address2
11. City*
12. State*
13. Zip*
15. Email*
17. Phone Number*
18. Citation Number*
20. Description of Violation *
    PLEASE LIST ALL VIOLATIONS THAT YOU WISH TO INCLUDE IN THIS REQUEST.
22. Type of Hearing Requested*
    -- Select One --Plea Hearing (you will speak with the Judge, enter a plea of guilty or no contest and resolve your violaiton)Indigent Hearing (you have entered a plea, are now unable to pay the amount owed, the Judge will consider your ability to pay and discuss any non-monetary compliance options)Pre-Trial Hearing (you will speak with the Prosecutor to discuss the facts of your case)
24. Today's Date*
    Today's Date

    Today's Date
25. Signature*

    You should expect to receive notification of your hearing date via email with in two business days, it is your responsibility to contact the court should you not receive your notice with in the provided timeframe. 

27. Acknowledgement*

    By signing this form you are being held to the same standards as if you completed the request in person. Failure to appear for the requested hearing could result in a warrant for your arrest. I further understand that if this request is not made at least twenty four hours prior to my Court Hearing that it will be denied and may result in a warrant for my arrest.

    1. I agree
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29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit Submit and Print

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