Intake Form - California Ticket King, PC

Who's filling out this form? *

In What COUNTY did you get the ticket? *

What INYO COUNTY Courthouse is the Cop sending you to? *

What IMPERIAL COURTHOUSE is the Cop sending you to? *

What KERN COURTHOUSE is the Cop sending you to? *

What LOS ANGELES COURTHOUSE is the Cop sending you to? *

What ORANGE COURTHOUSE is the Cop sending you to? *

What RIVERSIDE COURTHOUSE is the Cop sending you to? *

What SAN BERNARDINO COURTHOUSE is the Cop sending you to? *

What SAN DIEGO COURTHOUSE is the Cop sending you to? *

Violation Date

Did You Miss the First Court Date? *

Have you scheduled a future trial date? *

Full Name *

What's Your Date of Birth? *

Email Address *

Confirm Email Address *

Phone Number *

Driver's License Number

Do you hold a Commercial Driver's License?

Have You Attended Traffic School in the Last 18 Months?

What's Your Ticket/Citation Number? *

Upload file(s)Ticket or Citation

How Many Violations Are Listed?

Violation(s)

What's the Due Date? *

Has Bail Amount?

Bail Amount

USD

Is This a Speeding Over 100 MPH Ticket? *

What's the Issuing Officer's Last Name?

What Agency is the Officer With?

What's the Officer's Badge Number?

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal code

Country

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