Free TR-106 - California


File Size: 35.4 kB
Pages: 3
Date: June 24, 2009
File Format: PDF
State: California
Category: Court Forms - State
Word Count: 593 Words, 3,560 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.courtinfo.ca.gov/forms/documents/tr106.pdf

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CONTINUATION OF NOTICE TO APPEAR
(Face of Violator's Copy)

(Name of Agency and Jurisdiction) CONTINUATION OF NOTICE TO APPEAR
Date
1. 2.

c MISDEMEANOR cTraffic c Nontraffic

(Citation No.) Case No.

Time

/

/

AM PM

Day of Week

SMTWTFS
State

Name (First, Middle, Last) Veh. Lic. No. or VIN
3.

Correctable Violation (Veh. Code, 40610) Misdemeanor or Yes
4.c 5.c 6.c 7.c 8.c 9.c 10.c 11.c 12.c 13.c 14.c 15.c 16.c 17.c 18.c 19.c 20.c

No
c c c c c c c c c c c c c c c c c

Code and Section

Description

Infraction (Circle) M M M M M M M M M M M M M M M M M I I I I I I I I I I I I I I I I I

21.c Violations not committed in my presence, declared on information and belief.

I declare under penalty of perjury under the laws of the State of California the foregoing is true and correct, and a continuation of the enforcement document noted.
22.

Arresting or Citing Officer
23.

Serial No.

/ Date

/ Name of Arresting Officer, if different from Citing Officer Serial No.

24.

WITHOUT ADMITTING GUILT, I PROMISE TO APPEAR AT THE TIME AND PLACE INDICATED. X Signature SEE REVERSE TR-106

Judicial Council of California Form Rev. 01-01-04 (Veh. Code, 40500(b), 40513(b), 40522, 40600; Pen. Code, 853.9)

Shaded areas on the form indicate spaces subject to modification for local or agency requirements.

CONTINUATION OF NOTICE TO APPEAR
(REVERSE OF VIOLATOR'S COPY)

IMPORTANT -- READ CAREFULLY
This form is used when multiple offenses are charged and the original notice to appear form does not provide sufficient space for the listing of all the charges. PLEASE REFER TO THE REVERSE OF THE ORIGINAL NOTICE TO APPEAR FOR IMPORTANT INFORMATION REGARDING YOUR LEGAL OBLIGATIONS. CORRECTABLE VIOLATIONS: Those driver license, vehicle registration, and mechanical violations cited in accordance with Vehicle Code section 40610(a) will be dismissed by the court if PROOF OF CORRECTION and payment of a transaction fee are presented to the court by mail or in person on or before the appearance date. Violations of Vehicle Code section 16028 (automobile insurance) will be dismissed upon your showing to the court that evidence of financial responsibility was valid at the time this citation was issued. Proof of correction should be obtained for driver license, registration, and equipment violations. CORRECT EQUIPMENT VIOLATIONS IMMEDIATELY. METHODS FOR OBTAINING CERTIFICATION OF CORRECTION (Veh. Code, 40616): 1. Pollution control device violations must be certified by a smog check station licensed by the California Bureau of Automobile Repair. 2. Lamp, brakes, and exhaust system violations may be certified as corrected by an authorized inspection and installation station for the specific violation(s). 3. Registration and driver license violations may also be certified as corrected by an office of the Department of Motor Vehicles or by any clerk or deputy clerk of a court. 4. Proof of correction, except for violations that must be cleared at a certified inspection and installation station, may be obtained at ____________________________________ (fill in location) during regular business hours. CERTIFICATE OF CORRECTION (MUST BE RETURNED TO COURT) Signature of Person Certifying Correction Serial No. Agency

Section(s) Violated

Date

Shaded areas on the form indicate spaces subject to modification for local or agency requirements.

CONTINUATION OF NOTICE TO APEAR
(Reverse Of Court Copy)

(Circle one) RIGHT or LEFT THUMB PRINT

Shaded areas on the form indicate spaces subject to modification for local or agency requirements.