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INFRACTION VIOLATION BUREAU FORM
If your Infraction case does not have a disposition, you must complete this Admission-Nolo Contendere Form prior to submitting payment online.
USE OF FORM
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If your case does not have a disposition added by court (default judgment or guilty) and you are not paying the Infraction Deferral Agreement fees, you must complete this form. If your case is referred Failure To Appear, you must complete this form
DEFENDANT INFORMATION AND CASE INFORMATION
Name
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First
MI
Last
Address
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Street Address
City
State / Province / Region
Postal / Zip Code
Case Number or UTT Number
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All case numbers begin with 84H01 and must include -IF-
UTT number is found on your ticket
AGREEMENT TO TERMS PER INDIANA CODE IC 34-28-5-12 and IC 34-28-5-11
By submitting this form, you agree to waiving your rights as follows:
You understand by Admitting to the offense or pleading Nolo Contendere, a judgment will be entered against you it will become a part of your court record. You waive your rights to a public trial to the judge or to a jury. You waive your right to cross-examine any witness who testifies against you. You waive your right to have the assistance of counsel. You waive your right to call witnesses on your behalf. You waive your right for a jury trial. You acknowledge a conviction will be sent to the Bureau of Motor Vehicles of the state issuing your license which may result in additional suspensions, penalties and other requirements as imposed by the Bureau of Motor Vehicles. You hereby enter your appearance on the offense. You waive your rights as indicated above and answer the offense as follows
You must either ADMIT to the offense(s) or plead NOLO CONTENDERE (no contest) to the offenses(s)
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You are ADMITTING to the offense(s) for the case listed on this form. You understand you are waiving the rights as listed above and acknowledging any possible penalties
You are pleading NOLO CONTENDERE (no contest) to the offense(s) for the case listed on this form. You understand you are waiving the rights as listed above and acknowledging any possible penalties
Affirmation
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By entering your name and date in the above box, you affirm under penalty of perjury IC 35-44.1-2-1 you are the defendant and you are submitting this electronic form
PROCESSING TIME
Please allow up to three (3) business days processing time from date of submission to processing on your case. If you are scheduled for a court hearing, submission of payment may not cancel the hearing. The Terre Haute City Clerk's Office may reject any payments that do not meet the criteria for submission.
