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AGREEMENT TO PAY AND FORFEIT BAIL IN INSTALLMENTS (Vehicle Code, 40510.5) TICKET NUMBER: TO BE COMPLETED BY THE COURT Read carefully, and if you agree, type your name below and submit the form. 1. I am the defendant in this case, and I have been charged with the following infraction violation(s) of the Vehicle Code that do not require me to go into court: CASE NUMBER: b. c. d. e. a. 2. My court appearance date or extension date has not passed and I have provided proof of co.

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  2. Click the Get form button to open the document and start editing.
  3. Complete all the necessary fields (these are yellow-colored).
  4. The Signature Wizard will allow you to insert your electronic signature as soon as you?ve finished imputing data.
  5. Put the date.
  6. Look through the whole template to be certain you?ve filled out everything and no corrections are required.
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