§ 33.07 SUBMISSION FORM.

(___________________________) Undersigned agrees to the following:

1.   My Appearance and Submission to Jurisdiction of Ordinance Violations Bureau;

2.   Waiver of any right to Trial on charge of an Ordinance Violation in a Court of General Jurisdiction;

3.   Admit to violation of Jonesboro Ordinance_________________________by failure to comply with _____________________________ ____________________________________________________________________________________________________________________ _______________________________________________________________ ______________________________________________________

as set forth in the Complaint/Ticket No:____________________________ issued to me on _______________, 20_____;

4.   Agree to civil penalty of $___________________; and

5.   Agree to pay the penalty of $________ on or before ________________________, 20_;

                                 Dated:__________________________, 20__________

                                    ____________________________

                                          Signature

Printed Name:________________

   (_______) Undersigned denies Violation as set forth in the Complaint/Ticket No:________________I issued to me on ________________, ______20; and undersigned requests that such Complaint/Ticket be referred to the Jonesboro City Attorney for prosecution of the alleged Ordinance Violations in a Court of General Jurisdiction

                                 Dated:__________________________, 20__________

                                    ____________________________

                                          Signature

Printed Name:________________

(Ord. 2018-4, passed 8-12-2018)