2. Upon completion of your appearance please complete the form below:
4. Plea (choose one):*

   1. No Contest
   2. Guilty
6. GUILTY/NO CONTEST
   I have completed a virtual court appearance with the Bartonville Municipal Court. I hereby confirm my appearance by video conference and am entering my plea of NO CONTEST (or Guilty) to said offense charged; waive my right to a jury trial; waive my right to an appeal; and agree to the Court Orders discussed with me and processed today via my E-Court appearance. I understand and agree to pay the fines/fees ordered by the due date and to comply with all court ordered deadlines.
8. I acknowledge that the Judge and I discussed the Court ordered terms of:*

   1. Deferred Disposition
   2. Defensive Driving
   3. Extension to Pay a Judgement
   4. Payment Plan
   5. Community Service Requirements
   6. Other (complete below)
10. Other:
12. AND IT IS MY RESPONSIBILITY TO COMPLETE THE TERMS REQUIRED. FAILURE TO COMPLY WITH THE COURT ORDERED TERMS WILL RESULT IN A JUDGMENT OF CONVICTION AND FINES/FEES WILL BE DUE IMMEDIATELY. FAILURE TO COMPLETE THIS FORM WITHIN 2 BUSINESS DAYS OF YOUR ECOURT APPEARANCE WILL RESULT IN A “FAILURE TO APPEAR” OFFENSE FILED AGAINST YOU AND ISSUANCE OF AN ARREST WARRANT. A COPY OF THE COURT ORDER WILL BE EMAILED/MAILED TO YOU FOR YOUR RECORDS.
14. Citation Number*
15. Offense Charged*
17. First Name*
18. Last Name*
20. Date of Birth*
    Date of Birth
21. Driver's License State
22. Last 4 digits of Driver's License Number
24. Address1*
26. Address2
28. City*
29. State*
30. Zip*
32. Cell Phone Number*
33. Email*
35. Upon receipt of your completed form the Court Clerk’s office will mail a copy of the court order to you for your records.
37. By checking the "I agree" box below, you agree and acknowledge that 1) your plea will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.*

    1. I agree. Electronic Signature
39. Electronic Signature *
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41. Submit

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