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Extension for Time To Pay On Plea of Guilty or No Contest Resulting In A Conviction

  1. Request For Extension, Plea, And Conviction

    THIS IS NOT A REQUEST FOR A DISMISSAL OPTION, READ CAREFULLY AND COMPLETELY. Not all violations are eligible to use this form. You will be notified by court staff in those instances. This form allows you to make your plea of guilty or no contest and request an extension to pay the judgment that will be entered, resulting in a CONVICTION. You will have 30 days to pay the fine in full. On day 31, a $15 additional fee will be added. Any additional time to pay beyond 30 days must be requested in person or by mail. You may not make requests by phone, but you may call to inquire about other payment options. By using this form, you are representing to the Court that you have the ability to pay the fine and costs entered on the judgment. IF YOU ARE UNABLE TO PAY DO NOT USE THIS FORM. YOU MUST CONTACT THE COURT FOR ALTERNATIVES TO SATISFYING THE JUDGMENT. Your submission date will reflect the date the plea and request is filed with the court. Allow up to 10 days for court staff to process your request.

  2. Certain Convictions

    By voluntarily entering a plea of guilty or no contest using this form, the Defendant acknowledges the following: 1.) A conviction for moving violations will be reported to the State and may appear on your driving record. 2.) A conviction for a penal offense may be reported to the State and may have collateral consequences beyond a fine payment.

  3. I swear or affirm that the following statements are true:*

  4. Typing your name here represents your electronic signature.

  5. Leave This Blank:

  6. This field is not part of the form submission.