Fillable Form 2660: (CONFIDENTIAL) TRAFFIC OR OTHER INFRACTIONS SUPERIOR (The Superior Court of California - County of Orange)

Fill Online, Printable, Fillable, Blank Form 2660: (CONFIDENTIAL) TRAFFIC OR OTHER INFRACTIONS SUPERIOR (The Superior Court of California - County of Orange) Form

Use Fill to complete blank online THE SUPERIOR COURT OF CALIFORNIA - COUNTY OF ORANGE pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Form 2660: (CONFIDENTIAL) TRAFFIC OR OTHER INFRACTIONS SUPERIOR (The Superior Court of California - County of Orange)

On average this form takes 14 minutes to complete

The Form 2660: (CONFIDENTIAL) TRAFFIC OR OTHER INFRACTIONS SUPERIOR (The Superior Court of California - County of Orange) form is 3 pages long and contains:

  • 0 signatures
  • 46 check-boxes
  • 35 other fields

Country of origin: US
File type: PDF

Use our library of forms to quickly fill and sign your The Superior Court of California - County of Orange forms online.

BROWSE THE SUPERIOR COURT OF CALIFORNIA - COUNTY OF ORANGE FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
C$1127$))25'723$<),1(:
Page 1 of 3
T5$)),&$1'27+(5,1)5$&7,216
New 03/11/2019
Form #: L-776
Optional
CANNOT AFFORD TO PAY FINE:
TRAFFIC OR OTHER INFRACTIONS
(CONFIDENTIAL)
Citation/Case Number:
OC Pay Number:
Using this form:
• This form may be used after the court has decided that you owe the fine.
• If you can't afford to pay your fine, fill out this form to ask for a lower fine, a payment plan, more time to pay,
and/or community service.
• Use this form for traffic fines or other infractions.
• You may use this form if your fine has been sent to collections.
• If you have more than one citation, use a separate form for each citation.
• Mail or take this form to the court listed on your ticket.
Important!
Do not use this form to tell the court that you didn’t do anything wrong. See the instructions on your ticket and
visit www.occourts.org/directory/traffic/general-information/fees.html.

Your Information
Name: _________________________________________________ Social Security Number: __________________
Street/Mailing Address: _________________________ _____________________________ _______ __________
Street City
State  
Zip
Telephone: _________________________
OK to use this number for court reminders?
Yes No
Select ‘Yes’ if you authorize the court to send automated call reminders. Message & Data Rates may apply.
Email (optional)
:_________________________________
OK to send notices to this email? Yes
No
Select 'Yes' if you authorize the court to send electronic notices.

What type of income do you have?
I do not get money from any source. (Skip to Step 4 )

I get public benefits. (Check
all
that apply, then skip to Step 4)
For example:
Food stamps (CalFresh) State Supplementary Payment (SSP)
Medi-Cal County Relief/General Assistance
CalWORKs or Tribal TANF In-Home Supportive Services (IHSS)
Supplemental Security Income (SSI) Cash Assistance Program for Immigrants (CAPI)
Other need-based aid (specify): __________________________________________________________
CONFIDENTIAL
SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE
Central
-
700 Civic Center Dr. West, Santa Ana, CA 92701
-
4045
Harbor
-
4601 Jamboree Rd., Newport Beach, CA 9
2660
North
-
1275 N. Berkeley Ave., Fullerton, CA 92838
West
-
8141 13th Street, Westminster, CA 92683
Court Use Only
New 03/11/2019
CANNOT AFFORD TO PAY),1(
Page 2 of 3
Form #: L-776
TRAFFIC AND OTHER INFRACTIONS
Optional
CONFIDENTIAL
Citation/Case Number:
__________________
I do not get public benefits, but I get money from other sources. (Answer all that apply)
a. H
ow much money do you earn (take-home pay) or get from other sources (including income received in
your
family from a spouse or domestic partner)?
$ _____________
every: (Check one)
Year
Every Other Week
Week
Month
Other _______________________________
b. T
his money supports me and ________ other people.
c. I
f I pay the fine, I would: (Check all that apply, if any)
not have enough money to pay my rent/mortgage. I pay
$____________
for rent/mortgage every:
(Check one): Month
Week
Other: ___________________________
not have enough money to pay for other basic living expenses.
Basic living expenses
are things
like:
food, utilities, childcare, child support, transportation, medication, insurance (medical, car,
house, and
rental), and student loans.
not have enough money to pay my debt for other court cases.
List other court cases:
have other problems. (please explain):
_______________________________________________________________________________
______________________________________________________________________
_________
_______________________________________________________________________________
Do you have anything that shows your public benefits, income or expenses?
Things like an EBT card, paystubs, tax returns, rent or mortgage checks, or utility bills.
a. Ye
s, I have
attached copies of supporting documents.
Important! Only s
end copies (be sure to cross out any confidential information), keep the original
documents
for your own records. Any copies you attach can be destroyed after the court makes a
decision on your case.
b. No, I do not have a
ny papers to show because:
_____________________________________________________________________________
______
___________________________________________________________________________________
_________________________________
_____________________________________
_____________
Have you already told the court before that you can’t pay this fine?
Yes No (Skip to Step 3)
What circumstances have changed? (Check all that apply, if any)
Lost job or reduced hours at work
Started to receive public benefits
Suffered a serious illness or disability
Other: _____________________________________________________________________________
__
___________________________________________________________________________
New 03/11/2019
&$1127$))25'723$<),1(
Page 3 of 3
Form #: L-776
TRAFFIC AND OTHER INFRACTIONS
Optional
CONFIDENTIAL
Citation/Case Number:__________________
What are you asking the court to do? (Check all that apply)
Lower the amount I owe on the fine.
Payment plan: I want to pay the total fine (including $35
payment plan administrative fee) as:
$_________________
every
month on the ________ day of the month, until this fine
is paid off.
More time to pay:
Please change my deadline to (month/date/year):
________________________________________________
Community service instead of paying the fine. I understand that
community service may not be available on weekends or
evenings and other fees will apply
.
•
Some fines can't be reduced
just because you don't have
the money to pay.
•
You may ask for more time
to pay, community service,
and/or monthly payments
even if the court can't
reduce the fine.
I declare that I have no physical limitations that may prevent my
acceptance into the program.
Cancel or lower my civil assessment that was previously imposed for failing to appear on time.
Other information:
List other facts (if any) about why you can't pay the fine or about your choices in Step 5, (
attach other documents
that help you explain).
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________

Driver's license "hold" or suspension
Did you miss a court date or fail to pay a fine? If so, the Department of Motor (DMV) might have suspended or put a
"hold" on your driver's license. If the court clears your failure to appear, the court can notify the DMV. Yo
u must
still
contact the DMV to get your license back.

Read and sign below
I promise that the information above is correct. I declare under penalty of perjury, under the laws of the
State of California, that all information on or attached to this form is true. Perjury is a felony in California and
is punishable by imprisonment in the county jail for two, three, or four years. (Penal Code section 126).
Date: ____________________
______________________
Type or print your name
Sign your name
Print
Clear Form
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Form 2660: (CONFIDENTIAL) TRAFFIC OR OTHER INFRACTIONS SUPERIOR (The Superior Court of California - County of Orange)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 9 February 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document