Free Traffic Safety Course - Mississippi

File Size: 14.2 kB
Pages: 1
File Format: PDF
State: Mississippi
Category: Court Forms - State
Author: user
Word Count: 172 Words, 1,198 Characters
Page Size: Letter (8 1/2" x 11")

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IN THE JUSTICE COURT OF RANKIN COUNTY, MISSISSIPPI STATE OF MISSISSIPPI VS. _________________________ AFFIDAVIT STATE OF MISSISSIPPI COUNTY OF RANKIN I, ________________________________________ (hereinafter "Defendant"), being first duly sworn, depose and say: (a) (b) I understand that I am charged with __________________________________________. I hereby plead nolo contendere (no contest) to the above charge and request to participate in a traffic safety violator course as described in 63-9-11; (c) This is my first conviction of a violation under Chapter 3, 5 or 7 of Title 63 in more than three (3) years; (d) (e) I am not in the process of taking a course under 63-9-11; I have not completed a course under 63-9-11 that is not yet reflected on my public or nonpublic driving record; and (f) I understand that if the Department of Public Safety determines that any of the above information is false, a conviction for the above charge will be entered. ______________________________________ Defendant SWORN TO AND SUBSCRIBED TO BEFORE ME, this _____ day of _______________, 20____. Justice Court Clerk By: ______________________________ D.C. BOOK __________ PAGE __________ DEFENDANT