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2. IN THE COUNTY COURT OF THE FIFTH JUDICIAL CIRCUIT, IN AND FOR 
   CITRUS COUNTY, FLORIDA

4. Citation Number*

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6. STATE OF FLORIDA
   VS

8. Defendant's Name*

10. WRITTEN PLEA OF NOT GUILTY AND REQUEST FOR HEARING

12. I the above-named defendant, hereby acknowledge that I have been charged with a traffic infraction/ordinance violation in the County Court of Citrus County, Florida and I wish to enter a plea of NOT GUILTY to the charge. I hereby request that the Citrus County Clerk’s Office schedule my case for a hearing. I understand that by making this election I waive my right to the schedule of specified civil penalties. 

    I understand that at the hearing, the judge may impose one or more of the following penalties: 

    • In most cases a civil penalty not to exceed $1,000.00; some infractions may be over a $1,000.00 civil penalty. Section 318.14(5), FL Statute 
    • Mandatory attendance at a driver improvement school; Section 318.12(5), FL Statute 
    • Revocation or suspension of driving privileges: Section 316.655(5), FL Statute 
    • If ordered by the Court to pay court costs and fines, payment is required at the conclusion of the hearing. 
    • If you are unable to pay fines and costs in full, you may enroll in the Clerk’s Payment Plan for $25.00, due at the time of enrollment. 

    I understand that I will be notified by email, if provided or by U.S. mail of my date to appear before the court. I further understand that the hearing cannot be canceled or postponed except by the Court. 

    A hearing will be scheduled and requires the attendance of a County Court Judge or Hearing Officer, one or more Law Enforcement Officers, all witnesses, a Deputy Clerk of the Court, and a bailiff from the Sheriff's Office. If a continuance is necessary a motion must be submitted no less than fifteen (15) business days before the scheduled hearing date; otherwise the hearing will be held at the scheduled time without your presence. You must be on time. Your name will be called as it listed on the docket; the Court will not wait for you. You should plan to be in Court for 2 hours or longer. 

    I HEREBY CERTIFY that my address below is true and correct and that I will notify the Clerk’s office in writing of any change in said address within three (3) business days of such change.

14. MailingAddress*
16. City*
17. State*
18. Zip Code*
20. Telephone Number
21. Email Address
23. Was there any injury to anyone involved in the incident?

    1. Yes
    2. No
25. Are there any dates you will be unavailable in the next 60 days?
27. Do you have a commercial driver’s license?

    1. Yes
    2. No

    If yes, you understand that changes implemented by the Florida Department of Highway Safety and Motor Vehicles mean that withheld adjudication on a CDL license may not be recognized by the Department even if it was ordered by a Judge or Hearing Officer. The Clerk’s Office can only report the information as ordered and has no control over the final recording of the information.

29. Under penalties of perjury, I declare that I have read the foregoing plea and that the facts stated in it are true*

    Please enter your full legal name in the box above

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31. 1. Receive an email copy of this form.
32. Email address

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33. Submit Submit and Print

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