Form A Civil Infraction Response

NAME OF COURT

NAME OF COUNTY, NEVADA

STATE OF NEVADA,

Plaintiff,

vs.

NAME OF PERSON

CASE NO.:

CITATION NO.:

CIVIL INFRACTION RESPONSE

A peace officer has determined that you have committed one or more civil infractions. A civil infraction is a noncriminal violation that can lead to monetary penalties. This determination will be final UNLESS you contest it.

If you fail to pay or contest your civil infraction within 90 calendar days, the (name of court) will enter an order finding that you committed the civil infraction and enter a judgment for the total penalty prescribed for the civil infraction. In addition, you will be liable for a collection fee, and the outstanding balance will be referred to collections. You may not appeal the order. A record of the court’s order will be forwarded to the Department of Motor Vehicles (or the state where you received your license to drive) if you are found to have committed a civil infraction.

Please indicate below whether you wish to CONTEST or NOT CONTEST your civil infraction citation.

____ I, or my attorney on my behalf, wish to CONTEST my civil infraction citation. By signing below, I am requesting a contested hearing and will post cash bond in an amount equal to the total penalty amount.

_____ I, or my attorney on my behalf, DO NOT CONTEST my civil infraction citation. By signing below, I acknowledge that I am not contesting my civil infraction citation and agree to pay the total penalty amount.

__________________________________ _____________________

Print Name or Name of Attorney Bar Number (if attorney)

__________________________________ _____________________

Signature Date