READ PAYMENT PLANS INFORMATION BEFORE FILLING OUT FORM The State of Texas Vs * Citation Number * Date of Birth * Offense(s) * I, the undersigned, do request a payment plan for the citation named above hereby voluntarily enter my plea to the alleged violation, to wit: named above, charged in the Cross Roads Municipal Court. I hereby waive my right to a jury trial, waive my right to a copy of the complaint, (or if one has not been filed, waive my right to the preparation of a complaint) and decline my discovery rights pursuant to Art. 39.14 of the CCP. I seek to enter my plea and I hereby agree to pay the fine and costs the judge assesses. I understand that my plea of Guilty or No Contest may result in a conviction appearing on either a criminal record or a driver's license record. * Plea of Guilty Plea of Nolo Contendere (meaning "no contest") Defendent's Signature * Date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20222023202420252026 Mailing Address * Cell Phone Number * Email * Upload Driver's License/Photo ID * Files must be less than 5 MB.Allowed file types: gif jpg jpeg png pdf doc docx. Leave this field blank
