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2. Request for Information Fines
   Please fill out the form to request information pertaining to any outstanding outstanding fines and costs you may owe.
4. Name*
   The name of the person who owes the Fine
5. Email Address
   Email address you would like to receive your information
7. Address
   You can provide an address if you want to receive the information in the mail
9. City
10. State
11. Zip Code
13. Optional Description
    You may provide a description of your fines and costs. This could be helpful if you have multiple fines and costs for multiple arrests
Leave This Blank:


14. 1. Receive an email copy of this form.
15. Email address

    This field is not part of the form submission.

16. Submit

* indicates a required field