Microsoft Word - Traffic -aff of defense.docx

AFFIDAVITOFDEFENSEOR

ADMISSIONANDWAIVEROFAPPEARANCE

Name: CaseNo.

CitationNo. Driver’sLic.No.

Beforeme,personallyappear

ed, ,whoswearsoraffirmsasfollows:

1. Myname,addressandtelephonenum

berare:

Name:

Address:

Telephonenumber:

2. Iamthedefendantintheabov

ereferencedcaseandamchargedwiththefollowingviolation(s):(Listthe

charges,asyouunderstandthem)

(NOTE:Thisisnotanadmissionthatyouviolatedanylaw.)

3. Chooseandmarkonlyoneasyourplea:

 IherebypleadNOTGUILTYandfilethisaffidavitofdefenseasmyswornstatementherein.Iunderstand

thatwhenIpleadnotguilty,Idonothavetosupplyanyfurtherstatement.Iunderstandthatbymyfilingthis

affidavit,thehearingofficerorjudgewillhavetomakeadecisionastowhetherIcommittedthealleged

violationbythesworntestimonyofth

ewitnesses,otherevidence,andmystatement.IunderstandthatIam

waivingmypersonalappearanceatthefinalhearingofthismatter.

 IherebypleadGUILTYandfilethisaffidavitasanexplanationofwhathappenedandasastatementthat

thehearingofficerorjudgecanconsiderbeforepronouncingasentence.IunderstandthatIamnotrequiredto

makeanystatement.Iunderstandthatthehearingofficerorjudgewilldeterminetheappropriatesentenceand

decidewhethertoadjudi

catemeguilty.

 IherebypleadNOCONTESTandfilethisaffidavitasanexplanationofwhathappenedandasastatement

thatthehearingofficerorjudgecanconsiderbeforepronouncingasentence.Bypleadingnocontest,I

understandthatIamnotadmittingordenyingthattheinfractionwascommittedbutdonotcontestthe

charge(s),an

dIunderstandthatImaybesentencedandfoundguiltyeventhoughIenteredapleaofno

JD Peacock II

lerk of the Circuit Court, Okaloosa County, Florida

101 E James Lee Blvd

Crestview, FL 32536

850-689-5000

IntheFirst Judicial CircuitCourt,

inandforOkaloosa County,

Stateof Florida

contest.IunderstandthatIamnotrequiredtomakeanystatement.Iunderstandthatthehearingofficeror

judgewilldetermineanyappropriatesentenceanddecidewhethertoadjudicatemeguilty.

AFFIDAVITOFDEFENSE

4. Defendant’sStatement:(additionalpapers,documents,photos,etc.canbeattachedbutshouldbementioned

here)

Iun

derstandthatan

ymaterialmisrepresentationcouldcausemetobeprosecutedforaseparatecriminallaw

violation.

Affiant/Defendant

Swornto(oraffirmed)andsubscribedbeforeme,

Theundersignedauthority,on .

Personallyknownor Producedidentification

TypedofIDproduced

NotaryPublic or DeputyClerk

Name:

CommissionNumber:

MyCommissionExpires:

If you are a person with a disability who needs any accommodation in order to participate in this

proceeding, you are entitled, at no cost to you, to the provision of certain assistance. Please contact

Court Administration, ADA Liaison

Okaloosa County

1940 Lewis Turner Boulevard

Fort Walton Beach, Florida 32547

Phone (850) 609-4700 Fax (850) 651-7725

[email protected]

At least 7 days before your scheduled court appearance, or immediately upon receiving this notification if

the time before the scheduled appearance is less than 7 days; if you are hearing or voice impaired, call

711.

Revised 5/18/2019

PROCEDURES FOR USING AN AFFIDAVIT OF DEFENSE

1. Fill out the Affidavit of Defense including anything that you would want to state if you were to

personally appear for court.

2. Have the Affidavit of Defense notarized. (The Affidavit cannot be used as a sworn statement if

it is not notarized).

* This affidavit can only be used on an infraction citation when a court hearing is elected, not

mandated. This affidavit cannot be used on a mandatory infraction citation or a criminal

citation.

3. Please note that we are unable to accept personal or business checks. Include a money order or

cashier’s check for the full cost of the fine. (Please visit our website www.okaloosaclerk.com

and refer to our department fees, or call 850-689-5000. Your affidavit of defense and either

money order or cashier’s check must be received in our office no later than 7 calendar

days prior to the court date. Please exercise caution to include ample time for Court

holidays. Your Affidavit of Defense must be accompanied by a money order or cashier’s

check made payable to the Clerk of the Circuit Court for the full cost of the fine. If these

two items referenced above are not submitted within the allotted time, you will be required to

appear in person for your requested court date.

4. You can either mail your affidavit of defense and your form of payment or hand deliver to the

address below:

Clerk of the Circuit Court

Attention: Customer Service

101 E James Lee Blvd

Crestview, FL 32536

To keep you informed, we are required to send you a notice for the court date by e-mail or US

mail when you choose to use the Affidavit of Defense.

5. We will notify you of the outcome of your court hearing by mail. Your form of payment will be

applied toward the total of your imposed fine(s) and court costs. After applying your form of

payment to your case, you may still have an outstanding balance due. If your case is dismissed,

we will mail a refund to you in the amount that you submitted. If you wish to inquire on the

outcome of your case, prior to receiving your written notice, please call 850-689-5000. Before

calling to inquire please allow 48 hours following your scheduled court date.

If you have any questions or concerns, please contact the Clerk of the Circuit Court at 850-689-5000.

JD Peacock II

Clerk of the Circuit Court, Okaloosa County,

Florida

01 E James Lee Blvd

Cre

stview, FL 32536

850-689-5000