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2. Citation Number:
3. Citation Number (If multiple):
4. Citation Number (If multiple):
6. Name
7. Email
9. Mailing Address
   (Include PO Box and apartment number if any)
11. City
12. State
13. Zipcode
15. Phone Number
16. Fax Number (If applicable):
20. THE DATE OF THE PRE-TRIAL WILL BE MAILED TO YOU AFTER YOUR INITIAL APPEARANCE DATE
22. If you move, it is your responsibility to notify the court of your new address even if you updated your address with the Department of Motor Vehicles. The court’s system is not connected with the Department of Motor Vehicles.
24. I understand that if I mail or bring this plea form to the City of Whitewater Municipal Court before my initial appearance date, I will not have to appear at court until my pre-trial telephone conference with the city attorney.
26. Signature
    Type name here, then print and sign name.
27. Date
Leave This Blank:


29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit Submit and Print

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