New York Codes, Rules and Regulations › Title 15 - Department of Motor Vehicles › Chapter I - REGULATIONS OF THE COMMISSIONER › Subchapter G - Uniform Traffic Ticket, Form Of Waiver And Certifying And Recording Convictions › Part 92 - Form Of Waiver Under Section 1805, Vehicle And Traffic Law › Section 92.1 - Form of waiver

Current through Register Vol. 46, No. 28, July 10, 2024
Except as provided in section
					 92.2  of
					 this Part, the following form is to be used in disposing of certain traffic
					 infractions pursuant to the provisions of section 1805  of the Vehicle and Traffic Law.
PLEA OF GUILTY
Instructions to Motorists: Submit this form to the Court by
					 Registered or Certified mail, Return Receipt Requested. This form may not be
					 used for misdemeanors or for a third or subsequent speeding violation in an
					 18-month period. If the court denies this application, the applicant will be
					 notified to appear.
To:
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[] City
...............................................................................................................
[] Town
...............................................................................................................
[] Village COURT,
...............................................................................................................
[] City
...............................................................................................................
[] Town
[] Village OF __
I, __ residing at __ have been charged with __ committed on
					 __at __ I acknowledge receipt of the following warning:
"A PLEA OF GUILTY TO THIS CHARGE IS EQUIVALENT TO A
					 CONVICTION AFTER TRIAL. IF YOU ARE CONVICTED, NOT ONLY WILL YOU BE LIABLE TO A
					 PENALTY, BUT IN ADDITION YOUR LICENSE TO DRIVE A MOTOR VEHICLE OR MOTORCYCLE,
					 AND YOUR CERTIFICATE OF REGISTRATION, IF ANY, ARE SUBJECT TO SUSPENSION AND
					 REVOCATION AS PRESCRIBED BY LAW."
I waive arraignment in open court and the aid of Counsel. I
					 plead guilty to the offense as charged and elect and request that this charge
					 be disposed of and fine or penalty fixed by the court. I make the following
					 statement of explanation
					 (optional).............................................................
...............................................................................................................
...............................................................................................................
APPLICANTS UNDER 18 MUST COMPLETE THE
					 FOLLOWING
_____________________________________________________
Name of Parent or Guardian
...............................................................................................................
Address of Parent or Guardian
...............................................................................................................
___________________________________________________
All statements are made under penalty of perjury:
Date
...............................................................................................................
...............................................................................................................
Signed
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