CONTINUATION OF CITATION
(Face of Violator's Copy)
(Name of Agency and Jurisdiction) CONTINUATION s NOTICE TO APPEAR s NOTICE TO CORRECT VIOLATION OF CITATION Date of Violation Time
s MISDEMEANOR (Citation No.) s Traffic s Nontraffic Day of Week S M T W T F S Case No.
/ / 1 Name (First, Middle, Last)
2 Veh. Lic. No. or VIN
3 Correctable Violation (Veh. Code, § 40610)
AM PM
State
Yes
No s s s s s s s s s s s s s s s s s s
Code and Section
Description
Misdemeanor or Infraction (Circle)
4 s
M I _______________________________________________________________________ M I _______________________________________________________________________ M I _______________________________________________________________________ M I _______________________________________________________________________ M I _______________________________________________________________________ M I _______________________________________________________________________ M I _______________________________________________________________________ M I _______________________________________________________________________ M I _______________________________________________________________________ M I _______________________________________________________________________ M I _______________________________________________________________________ M I _______________________________________________________________________ M I _______________________________________________________________________ M I _______________________________________________________________________ M I _______________________________________________________________________ M I _______________________________________________________________________ M I _______________________________________________________________________
5 s
6s
7 s
8 s
9 s 10 s 11 s
12 s 13 s 14 s 15 s
16 s
17 s
18 s
19 s
20 s
21
Violations not committed in my presence, declared on information and belief.
I declare under penalty of perjury under the laws of the State of California the foregoing is true and correct, and a continuation of the enforcement document noted.
22
Arresting or Citing Officer
Serial No. Serial No.
23
/
Date
/
Name of Arresting Officer, if different from Citing Officer
24
WITHOUT ADMITTING GUILT, I PROMISE TO APPEAR AT THE TIME AND PLACE INDICATED. X Signature
Judicial Council of California Form Rev. 01-01-04 (Veh. Code, §§ 40500(b), 40513(b), 40522, 40600, 40610(d), 40618; Pen. Code, § 853.9)
SEE REVERSE TR-108
Shaded areas on the form indicate spaces subject to modification for local or agency requirements.
CONTINUATION OF CITATION
(Reverse of Violator's Copy)
IMPORTANT--READ CAREFULLY
This form is used when multiple offenses are charged and the original Notice to Appear / Notice to Correct Violation form does not provide sufficient space for the listing of all the charges. PLEASE REFER TO THE REVERSE OF THE ORIGINAL NOTICE TO APPEAR / NOTICE TO CORRECT VIOLATION FOR IMPORTANT INFORMATION REGARDING YOUR LEGAL OBLIGATIONS. CORRECTABLE VIOLATIONS ON A NOTICE TO APPEAR: Those driver license, vehicle registration, and mechanical violations cited in accordance with Vehicle Code section 40610(a) will be dismissed by the court if PROOF OF CORRECTION and payment of a transaction fee are presented to the court by mail or in person on or before the appearance date. Proof of correction should be obtained for driver license, registration, and equipment violations. CORRECT EQUIPMENT VIOLATIONS IMMEDIATELY. Violations of Vehicle Code section 16028 (automobile 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. CORRECTABLE VIOLATIONS ON A NOTICE TO CORRECT VIOLATION: Those driver license, vehicle registration, and mechanical violations cited in accordance with Vehicle Code section 40610(a) must be corrected and PROOF OF CORRECTION must be provided to the law enforcement agency's office designated on the reverse side of the Notice to Correct Violation form within 30 days in order to have the violation cleared. Proof of correction should be obtained for driver license, registration, and equipment violations. CORRECT EQUIPMENT VIOLATIONS IMMEDIATELY.
METHODS FOR OBTAINING CERTIFICATION OF CORRECTION (Veh. Code, § 40616): 1. Pollution control device violations must be certified by a smog check station licensed by the California Bureau of Automobile Repair. 2. Lamp, brakes, and exhaust system violations may be certified as corrected by an authorized inspection and installation station for the specific violation(s). 3. Registration and driver license violations may also be certified as corrected at an office of the Department of Motor Vehicles or by any clerk or deputy clerk of a court. 4. Proof of correction, except for violations that must be cleared at a certified inspection and installation station, may be obtained at __________________________________________________ (fill in location) during regular business hours.
CERTIFICATE OF CORRECTION (MUST BE RETURNED TO: s COURT, s CITING AGENCY)
Section(s) Violated Signature of Person Certifying Correction Serial No. Agency Date
Shaded areas on the form indicate spaces subject to modification for local or agency requirements.
CONTINUATION OF CITATION
(Reverse of Court's Copy)
(Circle one) RIGHT or LEFT THUMBPRINT
Shaded areas on the form indicate spaces subject to modification for local or agency requirements.