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2. First Name*
3. Last Name*
5. Date of Birth*
   Date of Birth
6. Email Address*
8. Phone Number*
10. Address1
12. Address2
14. City
15. State
16. Zip
18. Ticket Number

    Please enter your ticket/citation number. Ticket/citation numbers can be located on the top of your citation.  If you don't know your citation number type "Unknown".  Listing a citation number will help expedite your request.

19. Case Number

    Please enter your case number.  Case numbers start with the year (ex. 2021-XXXXX).  Not all cases have a case number.  If you do not know your case number leave this space blank.

21. Offense Type*
    -- Select One --Criminal/Copy of ChargesParking TicketTrafficUnsure
22. Request Status
    -- Select One --NONELost TicketCourt Date RequestMissed Court DateAttorney AssistancePay FineCourt Location RequestVictim AssistancePolice Report RequestReset Court DateIn-Person HearingAddress HearingNot A COSF Case
24. Other

    What else would you like for us to know?

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26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

* indicates a required field