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2. In the Midlothian Municipal Court, City of Midlothian, Ellis County, Texas
4. State of Texas VS
6. First Name*
7. Last Name*
9. Cause/Citation Number:*
10. List Each Offense (Ex: Speeding, Stop Sign, etc.): *
12. Mailing Address*
13. City*
15. State*
16. Zip*
17. Phone Number *
19. Email*
20. Submit Picture of Identification Card*
22. To find out the amount of your Citation click the below link
    Citation Amount

24. I, the above named Defendant do hereby enter my plea of NO CONTEST and waive my right to jury trial. I understand I have a right to a jury trial and my signature of this plea of nolo contendere (meaning “no contest”) will have the same force and effect as a plea of guilty of the judgment of the court. I understand my plea may result in a conviction appearing on either a criminal record or a driver’s license record. I knowledge and understand the provisions of this order and presented and agrees that he/she has the ability to fully comply. If any portion of the fine and costs is paid on or after the 31st day after the date of judgment, the Defendant shall pay an additional fee as required by Sec. 133.103 L.G.

    If defendant is unable to pay by the due date, defendant will be expected to pay a minimum of $100 down and submit a request for an installment agreement.  Defendant is ORDERED to notify the Court of any changes of address or financial situation that may hinder his/her ability to satisfy the judgment/order. Furthermore, I, the Defendant in the above numbered and entitled cause, do hereby acknowledge that I am hereby entering my plea and have not requested, and hereby waive any discovery pursuant Article 29.14 CCP.

26. I acknowledge that all of the information entered above is true and correct. PLEASE NOTE: It is your responsibility to enter a valid email address to receive orders from the court. A DocuSign Envelope will be emailed as listed on the online request form. Please check your junk/spam folder prior to calling the court office. Failure to submit required signatures may result in your case being set for court. *
27. Date*
    Date
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29. 1. Receive an email copy of this form.
30. Email address

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31. Submit Submit and Print

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