Extension Request

2. Please Note:
   By requesting an extension for any violation(s): I understand that I have a right to a jury trial and that my signature on this plea of nolo contendere (meaning "no contest") will have the same force and effect as a plea of guilty on the judgment of the Court. I do hereby plead nolo contendere to said offense as charged, waive my right to a jury trial or hearing by the Court, and agree to pay the fine and costs the judge assesses. I understand that my plea may result in a conviction appearing on either a criminal record or a driver's license record. Please note that a $15 Time Payment Fee will be assessed on the 31st day of your extension agreement(s) and failure to comply with this agreement(s) will result in a Capias Pro Fine warrant being issued.

   By requesting an extension for any violation(s): I understand that I have a right to a jury trial and that my signature on this plea of nolo contendere (meaning "no contest") will have the same force and effect as a plea of guilty on the judgment of the Court. I do hereby plead nolo contendere to said offense as charged, waive my right to a jury trial or hearing by the Court, and agree to pay the fine and costs the judge assesses. I understand that my plea may result in a conviction appearing on either a criminal record or a driver's license record. Please note that a $15 Time Payment Fee will be assessed on the 31st day of your extension agreement(s) and failure to comply with this agreement(s) will result in a Capias Pro Fine warrant being issued.

4. PLEASE ENTER PLEA *
   -- Select One --Guilty No Contest

6. First Name*

7. Last Name*

9. Address1*

11. City*

12. State*

13. Zip*

15. Date of Birth *
    Date of Birth

16. Phone Number *

17. Email Address*

19. Citation Number *

    Enter additional violations/ citations below.

20. Date of Citation*
    Date of Citation

21. Violation *

    Please enter the type of citation that was issued. Ex: ran stop sign

23. Citation Number

24. Date of Citation
    Date of Citation

25. Additional Violations

27. Citation Number

28. Date of Citation
    Date of Citation

29. Additional Violations

31. ACKNOWLEDGEMENT TO SUBMIT ADDITIONAL REQUIRED INFORMATION *

    1. I ACCEPT

    By checking the "I ACCEPT" box above, I am acknowledging that it is my responsibility to email the court a copy of my proof of driver’s license or identification to court@cedarhilltx.com which I will do so immediately upon submitting this form.

33. Extension Request Payment Plan Options *

    Please select an option.

    1. I will pay in full in 30 days.
    2. I need more than 30 days to pay in full.
35. Thank You ~ Cedar Hill Municipal Court
    Thank you for your submission. For additional information, questions or comments, please contact us by: Tel: 469-272-2930 ext. 1041 or Email: court@cedarhilltx.com

    Thank you for your submission. For additional information, questions or comments, please contact us by: Tel: 469-272-2930 ext. 1041 or Email: court@cedarhilltx.com

Leave This Blank:


37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit

* indicates a required field