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Request for Payment Arrangement, Resulting in a Conviction

  1. This form allows you to make your plea of guilty or no contest and request an extension or payment plan to pay the judgment that will be entered, resulting in a CONVICTION.
  2. IF YOU REQUEST A PAYMENT PLAN, you will be subject to a one-time $15 additional fee for EACH violation, required by the State. After submitting this form, you will be redirected to make a $100 down payment that is required to start a payment plan. We will determine a monthly minimum payment based off of your remaining balance and will email you a schedule upon your down payment.
  3. IF YOU REQUEST AN EXTENSION, you will have 30 days to pay the fine in full. On day 31, a $15 additional fee will be added.
  4. IF YOU ARE UNABLE TO PAY, DO NOT USE THIS FORM. Please click the following link to complete the Indigency request form.
  5. Your submission date will reflect the date the plea and request is filed with the court. Please allow up to 3-5 days for court staff to process your request.
  6. IF YOU REQUEST A PAYMENT PLAN, you will be subject to a one-time $15 additional fee for EACH violation, required by the State. After submitting this form, you will be redirected to make a $100 down payment that is required to start a payment plan. We will determine a monthly minimum payment based off of your remaining balance and will email you a schedule upon your down payment.

    IF YOU REQUEST AN EXTENSION, you will have 30 days to pay the fine in full. On day 31, a $15 additional fee will be added.  

  7. If you have multiple citations you would like to include in your extension or payment plan, you must list all of the citations below and provide a plea for each.
  8. Plea*
  9. Do you have another violation to add?*
  10. Plea
  11. Do you have another violation to add?
  12. Plea
  13. Do you have another violation to add?
  14. Plea
  15. Do you have another violation to add?
  16. Plea
  17. Do you have another violation to add?
  18. Plea
  19. Do you have another violation to add?
  20. I swear and affirm that the following statements are true:
    1. I am the person charged with this violation(s) and making this request voluntarily.
    2. I waive my right to a jury trial and waive any objection to the filing of a sworn complaint, notice, and any defect in the sworn complaint.
    3. I have read and acknowledge all the information provided in this form.
    4. I understand and acknowledge that a conviction for the violation(s) I have plead to may be reported to the State of Texas.
    5. I agree to update any change of address, email, or phone number to the court.
    6. In making this request I am representing to the court that I have the ability to pay the judgment(s).
    7. I agree to satisfy the judgment(s).
    8. I understand a conviction for a penal offense may be reported to the State and may have collateral consequences beyond a fine payment.
    9. By submitting this form, I swear that I am the named Defendant making the request.
  21. Upon submission of this form, you will be directed to a page with further instructions for your request. There will be separate instructions depending on whether you request a Payment Plan or an Extension. Please be sure to read the following page after you click Submit.
  22. Typing your name here represents your electronic signature.


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