Instruction: Replace the yellow values with yours.



Jan 1st, 2010


Traffic Clerk

Palo Alto Courthouse

Traffic Division

100 Grant Ave,

Palo Alto, CA 12345


RE: Mountain View Police Dept.

       Citation No: MV-12345

       Dated: Sept 1st, 2009;

        Docket No: DNO-1234567890.



Dear Traffic Clerk:


Regarding to the above-referenced citation and its date, I hereby waive the arraignment pursuant to California Vehicle Code (CVC) 40519 (b). I plead NOT GUILTY to the charge of CVC 12345.


I request a Trial by Written Declaration without waiving my right for speedy trial.


I enclose a bail check in the amount of $500.







Mr. MC

1000 Copper Street,

Ticket City, CA 12345