Official Court Application (OCA Form)
Official Court Application (OCA Form)
DEFENDANT'S WAIVER OF TRIAL BY JURY AND PLEA OF GUILTY/NO CONTEST
Comes now the Defendant in person and/or by and through his/her attorney of record and states that said Defendant understands the nature of the charge against him/her and the range of punishment for the offense charged; that he/she hereby waives the arraignment and reading of the complaint, and represents to the Court that the Defendant desires to make immediate disposition of this case by now entering a plea of GUILTY NO CONTEST. Further, the Defendant waives a trial by jury, the confrontation of witnesses, and the right to present witnesses in his/her own behalf, and submits the case to the Court on all issues of law and fact. Wherefore, Defendant prays that the court proceeds immediately on the filing hereof to accept the plea and waivers and to enter a judgment or deferred judgment of guilty in the manner provided by law.
Citation # :_________________________ $ ________ Citation # :_________________________ $ ________ Citation # :_________________________ $ ________ Citation # :_________________________ $ ________ Citation # :_________________________ $ ________ Citation # :_________________________ $ ________ Citation # :_________________________ $ ________ Payment Group # :_____________________________
Municipal Court Contact Information / Informaci?n de Contacto de Tribunal Municipal
Name/Nombre:_________________________________________________________________________________________________________
First/ Primer
Middle/ Segundo
Last/ Apellido
Home Address/ Direcci?n de domicilio:______________________________________________________________________________________
Apt #/ # De Apto.
City/State/Zip Ciudad/Estado/C?digo postal
Mailing Address/ Direcci?n postal:___________________________________________________________________________________________________
Home Phone/ Tel?fono del hogar:_________________ Cell #/ # de celular:______________________ Email/Correo Electr?nico: _____________________
_______________________
Date of Birth/ Fecha de nacimiento: ________________________
Sex/ Sexo M
F
Valid Government ID # Identificaci?n v?lida del gobierno _________________________ State or Country/Estado o Pa?s _________ Expiration/ Vencimiento: _______________________
Spouse's Name/Nombre de su esposa/o:__________________________________ Phone Number/N?mero de tel?fono:_____________________________
Marital Status/Estado Civil: Single/Soltero
Married/Casado
Separated/Separado
Divorced/Divorciado
Widowed/Viudo
ACKNOWLEDGEMENT- STANDARD PAYMENT PLAN ________________________________________________________________________________________________________________________________
1.) Defendant understands the payment plan terms. 2.) Defendant believes that they have the ability to successfully meet the payment plan terms. 3.) Defendant declines the opportunity for local program staff to review their payment ability information to consider lower monthly payments or a longer term.
Personal References / Referencia Personales
1)_________________________________ __________________________ 2)_________________________________ __________________________
Name/Nombre
Telephone/Telefono
Name/Nombre
Telephone/Telefono
I swear or affirm that the information is true, correct, and complete to the best of my knowledge.Juro afirmo que esta informaci?n es fiel, correcta y completa seg?n mi conocimiento.
X___________________________________________ _______________ X_____________________________________ _______________
Defendant Signature/Firma
Date/Fecha
Reviewed by Deputy Clerk/Subsecretario(a)
Date/Fecha
NOTICE: A $15.00 Fee will be due for criminal case(s) only if the total is not paid in full within 30 days of assessment. Only applicable for defendants on payment arrangements. Selected information may be subject to open records requests, in accord with State and Federal Law. Change of address or name information is required by State Law in Chapter 521 of the Transportation Code. ________ initial
Nota: Una tarifa de $15.00 por caso (s) criminal (s) solo si el total no se paga en su totalidad dentro de los 30 d?as posteriores a la evaluaci?n. S?lo aplicable a los demandados en los planes de pago. Informaci?n seleccionada puede estar sujeta a las solicitudes de registros abiertos, de acuerdo con el Estado y la ley federal. Cambiar de
direcci?n o nombre informaci?n es requerido por la ley del estado en 521 de cap?tulo del c?digo de transporte. ________ Inicial
Requirements (Office Use): Application Issued by _____________ Date
6A_____ Non 6A ______ (clerk initial)
________
Pay Type: Standard Pay Plan Collection Agency
Personal Info/Plan interview by ______________ Date _________
Amount Paid: Number ______________________________ of payments ________ Monthly Amt $ _______
Supervisor Review by _______________ Date ____________
30 Day 60 Day 0% Down
5% Down
10% Down 15% Down
Judge Set
App Issued: ________ App Completed: _________ Defendant Interview: ________ Wait time:_____ App Completed: _________ Process Time: ______
CTS-FRM-101
Revision 16 04/27/2021
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