Deferred Adjucation

List all the information below for deferred.  All the information must be true and correct for deferred to be consider.

Thanks,

Washington County Justice of the Peace Pct. Two 

DEFERRED DISPOSITION REQUEST 

              If you received a minor in possession of alcohol or tobacco citation, you must submit this form in person. All other applicants please fill out and return.  I understand that I can only make the request on or before my appearance date and must meet all eligibility requirements in order for the request to be granted by the court. I understand that Deferred is a privilege, not a right, offered at the sole discretion of the Court.  
I swear the following statements are true:  

1. I waive my right to trial and enter a plea of Guilty or No Contest
   • I was not charged with exceeding the posted speed limit in excess of 24 miles per hour, operating a motor vehicle without financial responsibility (if an accident was involved), subsequent charge of no proof of financial responsibility, or subsequent charge involving alcohol.
     • If the Court grants this request, I understand that I will be placed on probation for a period of time not to exceed six (6) months.
       • If the Court grants this request, I understand that the Court will require that I not be arrested or issued a citation any other Class C offense during my probationary period.
         • If the Court grants this request, I understand that the Court may impose additional requirements as it deems appropriate during my probationary period (i.e. attend classes, perform community service, submit to counseling, provide documentation, etc.) and, if ordered to do so, I understand that documented proof of requirements being met must be filed with the Court in accordance with the terms and conditions set forth in the Order of the Court.
           • If the Court grants this request, I understand that I must file a Statement of Compliance before the end of my probationary period affirming that I have complied with all the terms and conditions of my probation. If I have successfully complied with my probation, the Court will process this matter for DISMISSAL and a CONVICTION WILL NOT BE REPORTED.
             • And finally, if the Court grants this request and I fail to return a Statement of Compliance and/or FAIL TO COMPLY with all the terms and conditions of my probation, I understand that I will have a CONVICTION in this matter and offense will be reported as required by law.