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Please fill this form out according to the ticket you received.
ARIZONA TRAFFIC TICKET AND COMPLAINT Report Number
Complaint Social Security Number Military Accident
Driver's License # State License Class
Endorsements
M H N P T X D
DEFENDANT Name:First
Middle Initial
Last
Daytime Phone
--
Residential Address City State/Country ZipCode
Sex Weight Height Eyes Hair Origin Date of Birth / / MM/DD/YY Restrictions
ON
Date / /MM/DD/YY Time of Day Speed Approx Posted R&P
Sections: 1/A 2/B 3/C 4/D 5/E
YOU MUST APPEAR AT
Court #/Name
AT THE DATE INDICATED
/ /MM/DD/YY