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Email:

-Ticket Information-

Municipality:

Court Date:

Violation:

Ticket Number:

Have you had this infraction before:

Did You Blow?

Where were you when this occurred?

Where were you coming from? Friends, bars, ect:

Did the officer(s) ask you if you had anything to drink?

How many cops?

Did you do the field sobriety test*?

Who was with you?

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