Home
Our Services
Client Intake Form
New York Traffic Tickets
New York Cell Phone Tickets
New York Reckless Driving Tickets
New York Speeding Tickets
Commercial Trucking Violations
New York Traffic Law
TLC Traffic Violations
New York DUI / DWI
New York Refusal Hearings
New York Criminal Summons and Tickets
Driver Responsibility Assessment Program And Pedestrian Safety
Out of State Drivers
Community Support
Courts
Nassau County Traffic Courts
Suffolk County Traffic Courts
FAQ
Blog
News and Media
About Us
Contact Us
Take a Survey!
Fight your traffic tickets anywhere in NY State!
Client Intake Form
Client Intake Form
You are here:
Home
»
Client Intake Form
Client Intake Form
CONTACT INFORMATION
Last Name
*
First Name
*
Home/Work Phone
*
Cell Phone
Email Address
*
YOUR ADDRESS
Address Line 1
*
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Other
Zip
*
LICENSE INFORMATION
Date Of Birth
*
License Number
*
Car Make
Acura
Alfa Romeo
Aston Martin
Audi
Bentley
Benz
BMW
Cadillac
Chevrolet
Chrysler
Citroën
Corvette
Datsun
Dodge
Ferrari
Fiat
Ford
Honda
Hummer
Hyundai
Jaguar
Jeep
KIA
Lamborghini
Land Rover
Lexus
Lincoln
Maserati
Mazda
Mercedes-Benz
Mini
Mitsubishi
Nissan
Peugeot
Pontiac
Porsche
Renault
Rolls-Royce
Saab
Subaru
Suzuki
Toyota
Volkswagen
Volvo
Model
Year
Your Information
What is your occupation/job title?
Referrals
Advertisement
Internet
Friend/Family
Business
Other
TICKET INFORMATION
Ticket Number
Violation Date
Violation
ADULT SEAT BELT
BACKING UNSAFELY
CELLPHONE
CHILD SEAT BELT
DANGEROUS DRIVER
DISOBEY GREEN ARROW
DISOBEY STEADY RED
DISOBEY TRAFFIC DEVICE
DRIVER NO SEAT BELT
DROVE WRONG WAY
DUI
DWI
EXCESS WGHT LT 18000
EZ PASS
FLD TO COMPLY WITH ORD
FAIL TO STOP SCHOOL BUS
FAIL TO TURN AS REQ.
FLD PRESENT DOC -NYC
FLD TO SIGNAL LANE CHANGE
FLD TO STOP AT SIGN
FLD TO YLD PED CROSSWALK
FLD TO YLD TO EM.VH
FLD TO YLD TO PED
FOLLOW TOO CLOSELY
GREEN ARROW
IMP LEFT TURN-2WAY
IMPROPER CELLPHONE USE
IMPROPER RIGHT TURN
IMPROPER RT TURN INTER
IMPROPER SIGNAL
IMPROPER TAXI P/U
IMPROPER TURN
IMPROPER USE BUS LANE
IMPROPER UTURN
INSUFFICENT TURN SIGNAL
MOVED FROM LANE UNSAFE
NO SEAT BELT
NO UTURN
NYC REDLIGHT
OBSTRUCT CROSSWALK
OBSTRUCT INTERSECTION
OBSTRUCT TRAFFIC LANE NYC
OFF TRUCK ROUTE
OPEN CONTAINER
OP MV PORT ELEC DEV
OVRLOAD SING AXL NYC
RECKLESS DRIVING
RED ARROW
REDLIGHT
SCHOOL BUS
SPEED IN ZONE 1-10
SPEED IN ZONE 11-20
SPEED IN ZONE 11-30
SPEED IN ZONE 21-30
SPEED IN ZONE 31+
SPEED IN ZONE 31-40
SPEED UNPOSTED 11-30 NYC
SPILL BACK
SP-N/REA-PRUD
STOP SIGN
TRUCK RTE VIOLS NYC
UNLICENSED OPERATOR
UNPOSTED SPEED
UNREGISTERED VEHICLE
UTURN BUSIN DIST NYC
VEHICLE EQUIP VIOLATION
Other
County Where Ticket Was Written
Albany County
Allegany County
Bronx County
Broome County
Cattaraugus County
Cayuga County
Chautauqua County
Chemung County
Chenango County
Clinton County
Columbia County
Cortland County
Delaware County
Dutchess County
Erie County
Essex County
Franklin County
Fulton County
Genesee County
Greene County
Hamilton County
Herkimer County
Jefferson County
Kings County (Brooklyn)
Lewis County
Livingston County
Madison County
Monroe County
Montgomery County
Nassau County
New York County (Manhattan)
Niagara County
Oneida County
Onondaga County
Ontario County
Orange County
Orleans County
Oswego County
Otsego County
Putnam County
Queens County
Rensselaer County
Richmond County (Staten Island)
Rockland County
Saint Lawrence County
Saratoga County
Schenectady County
Schoharie County
Schuyler County
Seneca County
Steuben County
Suffolk County
Sullivan County
Tioga County
Tompkins County
Ulster County
Warren County
Washington County
Wayne County
Westchester County
Wyoming County
Yates County
Court
Question
Please attach any files or documents
Uploading Files. Please Wait.
Drop a file here or click to upload
Choose File
Maximum upload size: 67.11MB
Show Comments