Steuben county driver diversion program affadavit 2014 form-2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your name and address in the designated fields. Ensure that your contact information, including email and phone number, is accurate for any correspondence.
3. Indicate the town where the offense occurred and specify the nature of the ticket(s) you received.
4. In the statement section, fill in your birth date and confirm your request to participate in the program. Acknowledge that acceptance is discretionary.
5. Select either $250 or $150 as your administration fee based on your eligibility. Remember, this fee must be submitted if accepted into the program.
6. Answer all application questions with a 'Yes' or 'No' response. Be truthful, as false statements can lead to serious penalties.
7. If applicable, provide a brief explanation of any mitigating circumstances on the back of the form.
8. Compile all required documents: completed application, traffic ticket copy, driving record abstract, and a self-addressed stamped envelope before submission.

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