Diversion Program Registration for Those Represented by an Attorney Step 1 of 6 16% Thank you for participating in the Madison County, NY Diversion Program. This program is intended to help your client resolve their traffic violation quickly and easily, with no points on their license and with little or no impact on their automobile insurance policy premiums. This form is divided into three sections: Determine whether or not your client is eligible to participate in the program. Provide us with their personal information. Pay their fees using a credit card or debit card. Please be advised, in addition to the registration fee (which is based on the number of tickets your client has received at their traffic stop), the registrant will also be charged a 10% administration fee and a card payment fee (roughly 3% of the total). Each amount will be listed separately at the end of the registration process, as well as the total amount owed. Because your client is being represented by an attorney, if they are accepted into the program, the client will NOT be required to complete a defensive driving class. Once they have been accepted, the ticket(s) will be dismissed. You will need your client's drivers license, their traffic ticket(s), a picture or scan of their ticket(s) saved in JPG, PDF, PNG, or GIF format, and a method of payment (credit/debit card), in order to complete this process. If you have the proper information available, this process should take no more than fifteen (15) minutes to complete. If you have questions, please email us at help@DiversionConnect.com or call us at 866.250.6050. Section 1: Eligibility Most traffic violations will qualify for Diversion, but the Madison County District Attorney's office will be reviewing the application to determine eligibility and reserves the right to deny your client's participation in the program. You can use this site to submit your client's registration form and pay the fee, upload documents, and get answers to your questions. The application will then be reviewed by the Madison County District Attorney's Office. If your client's application is rejected, the application fee will be refunded. If your client is accepted into the Traffic Diversion Program your application fee is non-refundable. Some more serious Vehicle and Traffic violations may not be eligible for participation in the Traffic Diversion Program. You client is not eligible for the Traffic Diversion program if he/she meets any of the following criteria. (This is not an exhaustive list of reasons for exclusion.) Your client must not have been involved in a motor vehicle accident resulting in physical injury or death. The motorist must not have availed themselves of this or a similar program within 18 months of the date of the issuance of the Uniform Traffic Ticket. The motorist must not have three (3) or more moving violations within the past 18 months from application. The motorist must not have a suspended or revoked license for either a speeding, misdemeanor, or a persistent violator in the preceding 36 months. The motorist must not have a suspended license for "failure to answer a summons." The motorist must not have more than three (3) Uniform Traffic Tickets from any single traffic stop. The motorist must not have been disrespectful to the officer during the traffic stop. Important: If there is a property damage motor vehicle accident, the motorist must obtain an insurance indemnification letter from their insurance carrier indicating that the insurance carrier is on notice of the accident and that any claims will be honored. The District Attorney's Office will be reviewing this application to determine eligibility, based upon your client's driving record and any other aggravating circumstances. The District Attorney's Office will make the final determination as to your client's eligibility. By selecting "Yes" below ... You understand that completion of this form and submission of payment does not guarantee your client's acceptance into the Traffic Diversion Program. You understand that the payment is non-refundable unless your client is not accepted into the Madison County Traffic Diversion Program. Once accepted, the payment is non-refundable. You understand that regardless of your completion of this form, your client is required to appear in court on the date shown on their ticket(s) unless specifically told not to appear. If you wish to proceed with the application on behalf of your client, please check the "Yes" option below and hit the "Next" button. If you do not wish to continue, simply click here. You will be returned to the Madison County Diversion Program Website Home Page.I wish to continue* Yes **Please make sure to input all information completely and carefully. If your application is missing any component(s) you will be required to fill it out again.** Section 2: Registrant Contact Information Please complete all of the following fields. As the attorney, your email address is important. It will be used to confirm your client's application in this program. Failure to provide the correct email address may result in delays in the processing of the application and disqualification from the Diversion Program.Your Client's Name* First Last Your Client's Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AnguillaAntarcticaAntigua and BarbudaArab Republic of EgyptArgentine RepublicArubaBailiwick of GuernseyBailiwick of JerseyBaker IslandBarbadosBassas da IndiaBelizeBermudaBolivarian Republic of VenezuelaBosnia and HerzegovinaBouvet IslandBritish Indian Ocean TerritoryBritish Virgin IslandsBurkina FasoCanadaCayman IslandsCentral African RepublicClipperton IslandCo-operative Republic of GuyanaCommonwealth of AustraliaCommonwealth of DominicaCommonwealth of Puerto RicoCommonwealth of The BahamasCommonwealth of the Northern Mariana IslandsCook IslandsCoral Sea Islands TerritoryCzech RepublicDemocratic People’s Republic of KoreaDemocratic Republic of East TimorDemocratic Republic of Sao Tome and PrincipeDemocratic Republic of the CongoDemocratic Socialist Republic of Sri LankaDepartment of GuadeloupeDepartment of GuianaDepartment of MartiniqueDepartment of ReunionDominican RepublicEuropa IslandFalkland Islands (Islas Malvinas)Faroe IslandsFederal Democratic Republic of EthiopiaFederal Islamic Republic of the ComorosFederal Republic of GermanyFederal Republic of NigeriaFederated States of MicronesiaFederation of Saint Kitts and NevisFederative Republic of BrazilFrench RepublicGabonese RepublicGaza StripGeorgiaGibraltarGlorioso IslandsGrand Duchy of LuxembourgGreat Socialist People’s Libyan Arab JamahiriyaGreenlandGrenadaHashemite Kingdom of JordanHellenic RepublicHong Kong Special Administrative RegionHowland IslandIndependent Stat of Papua New GuineaIndependent State of SamoaInternational bodies of waterInternational undersea featuresIrelandIslamic Republic of AfghanistanIslamic Republic of IranIslamic Republic of PakistanIsle of ManItalian RepublicJamaicaJan MayenJapanJarvis IslandJohnston AtollJuan de Nova IslandKingdom of BahrainKingdom of BelgiumKingdom of BhutanKingdom of CambodiaKingdom of DenmarkKingdom of LesothoKingdom of MoroccoKingdom of NepalKingdom of NorwayKingdom of Saudi ArabiaKingdom of SpainKingdom of SwazilandKingdom of SwedenKingdom of ThailandKingdom of TongaKingdom of the NetherlandsKingman ReefKyrgyz RepublicLao People’s Democratic RepublicLebanese RepublicMacau Special Administrative RegionMalaysiaMidway IslandsMongoliaMontserratMyanmar (Burma)Navassa IslandNegara Brunei DarussalamNetherlands AntillesNew ZealandNiueOriental Republic of UruguayPalmyra AtollParacel IslandsPeople’s Democratic Republic of AlgeriaPeople’s Republic of BangladeshPeople’s Republic of ChinaPitcairn, Henderson, Ducie, and Oeno IslandsPortuguese RepublicPrincipality of AndorraPrincipality of LiechtensteinPrincipality of MonacoRepublic of AlbaniaRepublic of ArmeniaRepublic of AustriaRepublic of AzerbaijanRepublic of BelarusRepublic of BeninRepublic of BoliviaRepublic of BotswanaRepublic of BulgariaRepublic of BurundiRepublic of CameroonRepublic of Cape VerdeRepublic of ChadRepublic of ChileRepublic of ColombiaRepublic of Costa RicaRepublic of Cote d’IvoireRepublic of CroatiaRepublic of CubaRepublic of CyprusRepublic of DjiboutiRepublic of EcuadorRepublic of El SalvadorRepublic of Equatorial GuineaRepublic of EstoniaRepublic of FinlandRepublic of GhanaRepublic of GuatemalaRepublic of GuineaRepublic of Guinea-BissauRepublic of HaitiRepublic of HondurasRepublic of HungaryRepublic of IcelandRepublic of IndiaRepublic of IndonesiaRepublic of IraqRepublic of KazakhstanRepublic of KenyaRepublic of KiribatiRepublic of KoreaRepublic of LatviaRepublic of LiberiaRepublic of LithuaniaRepublic of MadagascarRepublic of MalawiRepublic of MaldivesRepublic of MaliRepublic of MaltaRepublic of MauritiusRepublic of MoldovaRepublic of MozambiqueRepublic of NamibiaRepublic of NauruRepublic of NicaraguaRepublic of NigerRepublic of PalauRepublic of PanamaRepublic of ParaguayRepublic of PeruRepublic of PolandRepublic of San MarinoRepublic of SenegalRepublic of SeychellesRepublic of Sierra LeoneRepublic of SingaporeRepublic of SloveniaRepublic of South AfricaRepublic of SurinameRepublic of TajikistanRepublic of Trinidad and TobagoRepublic of TunisiaRepublic of TurkeyRepublic of UgandaRepublic of UzbekistanRepublic of VanuatuRepublic of YemenRepublic of ZambiaRepublic of ZimbabweRepublic of the CongoRepublic of the Fiji IslandsRepublic of the GambiaRepublic of the Marshall IslandsRepublic of the PhilippinesRepublic of the SudanRepublic on AngolaRomaniaRussian FederationRwandese RepublicSaint HelenaSaint LuciaSaint Vincent and the GrenadinesSerbia and MontenegroSlovak RepublicSocialist Republic of VietnamSolomon IslandsSomaliaSouth Georgia and the South Sandwich IslandsSpratly IslandsState of EritreaState of IsraelState of KuwaitState of QatarSultanate of OmanSvalbardSwiss ConfederationSyrian Arab RepublicTaiwanTerritorial Collectivity of MayotteTerritorial Collectivity of Saint Pierre and MiquelonTerritory of Ashmore and Cartier IslandsTerritory of Christmas IslandTerritory of Cocos (Keeling) IslandsTerritory of French PolynesiaTerritory of GuamTerritory of Heard Island and McDonald IslandsTerritory of New Caledonia and DependenciesTerritory of Norfolk IslandTerritory of the French Southern and Antarctic LandsTerritory of the Wallis and Futuna IslandsThe Former Yugoslav Republic of MacedoniaThe Holy See (State of the Vatican City)Togolese RepublicTokelauTromelin IslandTurkmenistanTurks and Caicos IslandsTuvaluUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited Mexican StatesUnited Republic of TanzaniaUnited States Virgin IslandsUnited States of AmericaWake IslandWest BankWestern Sahara Country Attorney's Name* First Last Attorney's Bar Registration Number* Please keep this number accessible. You will need to enter this every time you complete this form on behalf of a client.Attorney's Firm* What is the name of the firm you work for?Attorney's Business Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AnguillaAntarcticaAntigua and BarbudaArab Republic of EgyptArgentine RepublicArubaBailiwick of GuernseyBailiwick of JerseyBaker IslandBarbadosBassas da IndiaBelizeBermudaBolivarian Republic of VenezuelaBosnia and HerzegovinaBouvet IslandBritish Indian Ocean TerritoryBritish Virgin IslandsBurkina FasoCanadaCayman IslandsCentral African RepublicClipperton IslandCo-operative Republic of GuyanaCommonwealth of AustraliaCommonwealth of DominicaCommonwealth of Puerto RicoCommonwealth of The BahamasCommonwealth of the Northern Mariana IslandsCook IslandsCoral Sea Islands TerritoryCzech RepublicDemocratic People’s Republic of KoreaDemocratic Republic of East TimorDemocratic Republic of Sao Tome and PrincipeDemocratic Republic of the CongoDemocratic Socialist Republic of Sri LankaDepartment of GuadeloupeDepartment of GuianaDepartment of MartiniqueDepartment of ReunionDominican RepublicEuropa IslandFalkland Islands (Islas Malvinas)Faroe IslandsFederal Democratic Republic of EthiopiaFederal Islamic Republic of the ComorosFederal Republic of GermanyFederal Republic of NigeriaFederated States of MicronesiaFederation of Saint Kitts and NevisFederative Republic of BrazilFrench RepublicGabonese RepublicGaza StripGeorgiaGibraltarGlorioso IslandsGrand Duchy of LuxembourgGreat Socialist People’s Libyan Arab JamahiriyaGreenlandGrenadaHashemite Kingdom of JordanHellenic RepublicHong Kong Special Administrative RegionHowland IslandIndependent Stat of Papua New GuineaIndependent State of SamoaInternational bodies of waterInternational undersea featuresIrelandIslamic Republic of AfghanistanIslamic Republic of IranIslamic Republic of PakistanIsle of ManItalian RepublicJamaicaJan MayenJapanJarvis IslandJohnston AtollJuan de Nova IslandKingdom of BahrainKingdom of BelgiumKingdom of BhutanKingdom of CambodiaKingdom of DenmarkKingdom of LesothoKingdom of MoroccoKingdom of NepalKingdom of NorwayKingdom of Saudi ArabiaKingdom of SpainKingdom of SwazilandKingdom of SwedenKingdom of ThailandKingdom of TongaKingdom of the NetherlandsKingman ReefKyrgyz RepublicLao People’s Democratic RepublicLebanese RepublicMacau Special Administrative RegionMalaysiaMidway IslandsMongoliaMontserratMyanmar (Burma)Navassa IslandNegara Brunei DarussalamNetherlands AntillesNew ZealandNiueOriental Republic of UruguayPalmyra AtollParacel IslandsPeople’s Democratic Republic of AlgeriaPeople’s Republic of BangladeshPeople’s Republic of ChinaPitcairn, Henderson, Ducie, and Oeno IslandsPortuguese RepublicPrincipality of AndorraPrincipality of LiechtensteinPrincipality of MonacoRepublic of AlbaniaRepublic of ArmeniaRepublic of AustriaRepublic of AzerbaijanRepublic of BelarusRepublic of BeninRepublic of BoliviaRepublic of BotswanaRepublic of BulgariaRepublic of BurundiRepublic of CameroonRepublic of Cape VerdeRepublic of ChadRepublic of ChileRepublic of ColombiaRepublic of Costa RicaRepublic of Cote d’IvoireRepublic of CroatiaRepublic of CubaRepublic of CyprusRepublic of DjiboutiRepublic of EcuadorRepublic of El SalvadorRepublic of Equatorial GuineaRepublic of EstoniaRepublic of FinlandRepublic of GhanaRepublic of GuatemalaRepublic of GuineaRepublic of Guinea-BissauRepublic of HaitiRepublic of HondurasRepublic of HungaryRepublic of IcelandRepublic of IndiaRepublic of IndonesiaRepublic of IraqRepublic of KazakhstanRepublic of KenyaRepublic of KiribatiRepublic of KoreaRepublic of LatviaRepublic of LiberiaRepublic of LithuaniaRepublic of MadagascarRepublic of MalawiRepublic of MaldivesRepublic of MaliRepublic of MaltaRepublic of MauritiusRepublic of MoldovaRepublic of MozambiqueRepublic of NamibiaRepublic of NauruRepublic of NicaraguaRepublic of NigerRepublic of PalauRepublic of PanamaRepublic of ParaguayRepublic of PeruRepublic of PolandRepublic of San MarinoRepublic of SenegalRepublic of SeychellesRepublic of Sierra LeoneRepublic of SingaporeRepublic of SloveniaRepublic of South AfricaRepublic of SurinameRepublic of TajikistanRepublic of Trinidad and TobagoRepublic of TunisiaRepublic of TurkeyRepublic of UgandaRepublic of UzbekistanRepublic of VanuatuRepublic of YemenRepublic of ZambiaRepublic of ZimbabweRepublic of the CongoRepublic of the Fiji IslandsRepublic of the GambiaRepublic of the Marshall IslandsRepublic of the PhilippinesRepublic of the SudanRepublic on AngolaRomaniaRussian FederationRwandese RepublicSaint HelenaSaint LuciaSaint Vincent and the GrenadinesSerbia and MontenegroSlovak RepublicSocialist Republic of VietnamSolomon IslandsSomaliaSouth Georgia and the South Sandwich IslandsSpratly IslandsState of EritreaState of IsraelState of KuwaitState of QatarSultanate of OmanSvalbardSwiss ConfederationSyrian Arab RepublicTaiwanTerritorial Collectivity of MayotteTerritorial Collectivity of Saint Pierre and MiquelonTerritory of Ashmore and Cartier IslandsTerritory of Christmas IslandTerritory of Cocos (Keeling) IslandsTerritory of French PolynesiaTerritory of GuamTerritory of Heard Island and McDonald IslandsTerritory of New Caledonia and DependenciesTerritory of Norfolk IslandTerritory of the French Southern and Antarctic LandsTerritory of the Wallis and Futuna IslandsThe Former Yugoslav Republic of MacedoniaThe Holy See (State of the Vatican City)Togolese RepublicTokelauTromelin IslandTurkmenistanTurks and Caicos IslandsTuvaluUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited Mexican StatesUnited Republic of TanzaniaUnited States Virgin IslandsUnited States of AmericaWake IslandWest BankWestern Sahara Country Attorney's Phone Number*Be sure to include your area code.Attorney's Preferred Contact Number*This can be the same as the phone number above or it can be another number. Be sure to include your area code.Attorney's preferred contact number is my ...* Cell Phone Home Phone Work Phone Attorney's Email Address*(please enter your email address twice) Enter Email Confirm Email All of the information requested below can be found on your client's New York State Driver's License. Out-of-state drivers will have similar information on their licenses.Client Driver's License Issuing State/Province*Use abbreviations only -- e.g., NY, PA, OH, ON. If your client does not have a license, please enter the state or province where you currently live. DMV ID Number from your Client's Driver's License*No spaces or dashes -- numbers and/or letters only. Examples shown above circled in red. If you do not have a driver's license, please enter "No License." Client's Drivers License Expiration Date*Date (examples shown above, circled in green). If your client does not have a license, please enter today's date. MM slash DD slash YYYY Automobile Insurance Information All of the information requested below can be found on the New York State Insurance Identification Card that your client keeps in his/her vehicle. Other states have similar documentation requirements.HiddenClient's Automobile Insurance Companye.g., Allstate, GEICO, State Farm HiddenClient's Insurance Policy Number HiddenClient's Insurance Policy Expiration Date MM slash DD slash YYYY Section 3: Violation InformationPlease complete all of the following fields. It is critical that you enter your client's ticket number(s) correctly into the appropriate field(s) below and upload pictures or scans of your client's violation(s). Failure to provide all required information will result in delays in the processing of your client's application and possible disqualification from the Diversion Program. Be sure to include the ticket numbers from all outstanding citations. Tickets not listed will not be eligible for inclusion in the Diversion Program and your client will be required to appear in court.When did your client's traffic stop occur?*If you're not sure, please refer back to the citation received. MM slash DD slash YYYY Using the above diagram and your traffic citation(s) as a reference, please answer the following questions ...Citation Number*Enter the citation number displayed in the upper left corner of the ticket. The citation (or ticket) number is shown in the above image circled in ORANGE. DO NOT ENTER THE TICKET NUMBER FROM THE SAMPLE TICKET PICTURED ABOVE! YOU MUST USE THE TICKET NUMBER(S) THAT APPEAR ON THE PAPER VERSION(S) YOUR CLIENT RECEIVED AT THEIR TRAFFIC STOP! If your client received more than one (1) citation during this traffic stop, select any one of the citation numbers for this field. This will serve as the unique identifier. Please re-enter the above Citation Number (for confirmation)* If (and only if) your client received more than one citation during the traffic stop, enter the remaining ticket numbers below. Enter the citation number for each ticket you received. DO NOT INCLUDE THE TICKET YOU ENTERED IN THE PREVIOUS FIELD ABOVE.Enter one citation number per line. The citation (or ticket) number is shown in the above image circled in ORANGE.Violations List Instructions Enter the Violation Section Number and the Description of Violation from your client's citation in the Violations List field below. This number is shown in the above sample image circled in BLUE. If your client received more than one citation during the traffic stop, you must enter the violation section numbers for ALL tickets you are submitting today.Violations List*Abandoned Vehicle | 1224-7AAbandoning Vehicle | 1224-7Agg Fail To Answer Appearance Ticket | 511-D1Aggravated Unlic Op 3Rd (Misd) | 511-1(A)Aggravated Unlic Oper-2Nd Deg. | 511-2A2Aggravated Unlic Oper-2Nd/Mandatory Suspension | 511-2A3Aggravated Unlic Oper-2Nd/Previous Conviction | 511-2A1Aggravated Unlicensed Operation - 2Nd Degree (Misd) | 511-2A4Allowing Use Of License | 509-6AAlter Doucment/Plate | 392-5Attaching Self To Moving Motor Vehicle | 1233-2Avoiding Traf Device Or Intersect | 1225Back Seat Pass Age 4-7 No/Improper Restraint | 1229-C1BBack Seat Pass Age 8-15 No/Impropr Seat Belt | 1229-C1CBack Seat Pass Less Than 4 No/Imp Restraint | 1229-C1ABacking On Controlled-Access Hgwy | 1211-BBacking Unsafely | 1211-ABic, Pushcart/Animal On Expressway | 1229-ABBicy Fld/To Stop Entering Roadway | 1234-CCarrying Articles On Bicycles | 1235Cert. Issued W/O Complete Inspect. | 306-DCertain Veh Failed Stop Before Rr Crossing Cleared | 1171-C1Certain Veh Failed To Slow At Rr Crossing | 1171-CClinging To Moving Motor Vehicle | 1233-1Clinging To Other Vehicle- Mcy | 1253Coasting W/Gears In Neutral | 1216Commer Advert On Traf Cntl Device | 1114-BConsume Alch.While On Duty Oper Bus | 509-L1BCrossed Fire Hose | 1218Dealer Acquring Lmt Use Veh W/O Vin | 2267-2Defacing/Alters/Removing Notice Of Bridge Closure | 1629-2Destroy/Remove Fail Notify | 2285-5Disobeyed Traffic Control Device | 1110-ADisobeyed Traffic Device Hov Lane | 1110-AHDisplayed Forged Cert. Of Inspection (Misd) | 306-EDisplayed Unauthor Traf Cntl Device | 1114-ADisposing/Vehicular Scrap Illegally | 415-A10CDocument Obtained Unlawfully | 392-2Driver'S View Obstructed | 1213-ADriv'G In Shoulder / Lmt Acess Hgwh | 1131Driving Below Minimum Posted Speed Limit | 1181-BDriving In Center Lane | 1128-BDriving/Left On Crest Grade/Curve | 1125-A1Driving On Sidewalk | 1225-ADriving Over Dividing Space | 1130-1Driving Thru Safety Zone | 1221Driving To Left At Bridge Or Tunnel | 1125-A3Driving To Left At Railrd Crossing | 1125-A2Driving To Left Of Pavement Markings | 1126-ADriving Too Slow | 1181-ADriving/Wrong Direc On One-Way Strt | 1127-ADrove Across Hazard Marking | 1128-DDrove Thru (Around/Undr) Cross Gate | 1170-BDrove Wrong Way (Traffic Island) | 1127-BDump/Shovel Snow Handicap Park Area | 1203-EDwi/Drugs Atv | 2404-1HEmploy Of Unfit Person | 394-9Employing Disqualified Bus Operator | 509-D4Equestrian Carrying Article | 1263Equestrian Failed To Ride Single File | 1262-BEquestrian Failed To Stop Before Entering Hwy | 1262-CEquestrian Interfered With Flow Of Traffic | 1262-AEquestrian Riding At Night | 1264Equip. Vio. Limited Use Veh. | 2265-1Erased Record Of Convictions | 515Escorting W/ Cancelled Cert | 551-2Escorting W/O Cert | 551-1Exceeding Clearance | 385-14Exceeding Restricted Weight On Restricted Hwy | 1625Excessive Noise/ Moving | 386-3AExcessive Noise/Operating Mcy | 386-3DExcessive Noise/Operating Mot.Veh. | 386-3CExcessive Noise/Stationary Mgw 10000 Lbs | 386-3BFacil Aggrav Unlic Oper, 3Rd Deg. | 511-A1Facilitating Aggravated Unlic Oper | 511-AFacilitating Aggravated Unlic Oper (Misd) | 511-A3Fail Comply With Order | 2404-2BFail Display/Give Notice/Reinspect. | 303-CFail Record Mileage | 301-C1Fail Surrender After Revocation (Misd) | 318-7Fail/Surrender Inspect. Items | 303-GFail To Produce Insur/Person Injured On Atv | 2407-3Fail To Remove Plates On Transfer | 420-1Fail/Yield Right-Of-Way | 2404-2AFailed To Change Address/Reg | 401-3Failed To Comply W/Lawful Order | 1102Failed To Cover Loose Cargo | 380-AFailed To Cover Loose Cargo | 380-A1Failed To Deliver Disclosure Document | 417-A3Failed To Deliver Suspended/Revoked Dealer Item | 415-11Failed to Dim Headlights | 375-03Failed To Give Audible Warning On Mountain Highway | 1215-AFailed To Give One Half Of Rdwy | 1121Failed To Give Way | 1122-BFailed To Keep Records Or Dept Improper Records | 415-A5AFailed To Keep Right | 1120-AFailed To Keep Right/4 Or More Lane | 1120-CFailed To Keep Right/Slow Move Veh | 1120-BFailed To Provide Cert Of Prior Use Driver Ed Veh | 417-A1BFailed To Provide Vin | 431Failed To Remove Haz Mat From Hwy | 1219-BFailed To Report Judgement | 336Failed To Report Property Damage Accident | 605-BFailed To Report Recovery Veh/Person | 2129-BFailed To Report Unclaimed Vehicle | 2129-CFailed To Require Test Or Exam. | 509-GFailed To Safely Pass A Bicycle | 1122-AFailed To Stop At Malfunctioning Traffic Light | 1117Failed To Surrender Revoded/Suspended Repair | 398-E4Failed To Surrender Title | 2130-B2Failed To Use Designated Lane | 1128-CFailed To Use Due Care Approaching Horse | 1146-A1Failed To Yld/Grn Arrow | 1111-A2Failed To Yld Rt-Of-Way-Grn Lite | 1111-A1Failure Of Dealer/Maintain Records | 2114-BFailure Of Dealer To Provide Disclosure | 417-BFailure Of Dealer To Provide Disclosure | 417-B1Failure Of Peace Officer Report Theft/Veh | 2129-AFailure Sch-Bus Driver Use Seatbelt | 383-4AFailure To Changes Address | 2285-3Failure To Display Plates Atv | 2283-1Failure To File Amended/New Application | 398-C3BFailure To Hold Valid Estimators License | 398-D5Failure To Keep Inspection Records | 303-BFailure To Keep Required Records | 394-7Failure To Keep Right-Bicycle | 1234-AFailure To Notify Comm Of Recovery Of Title Cert | 2112-BFailure To Provide Used Car Cert. | 417Failure To Provide Used Car Cert | 417-A2Failure To Record Mileage/Inspection Sticker | 301-C1AFailure To Report Accident (Misd) | 2413-4Failure To Review Driving Record | 509-EFailure To Signal Stopping (Decreasing Speed) | 1163-CFailure To Submit Affidavit | 509-JCFailure To Trans. Reg. | 2285-4False Statement-Document Or Plate Application | 392Falsifying Temp Indicia Of Reg | 403-AFicitious Inspection Station Lic (Misd) | 306-FFld/Allow Space/Caravan/Mtrcade | 1129-CFld/Bus Driver/Notify Emp./Susp/Rev | 509-IFld/Deliver Title Cert/Lien Hold | 2119-AFld/Deliver Title/Transferee | 2130-B3Fld/Display Num. Plates | 2264-1Fld Due Care For Emerg Veh Stopped Or Standing | 1144-AAFld Due Care For Haz Veh Stopped Or Standing | 1144-ABFld/Equip Sch Bus W/Seatbelt-Driver | 383-4Fld/Keep, Improper Rec.Scrap Col. | 415-A10BFld/Keep School Bus Halted/Lighted | 1174-BFld/Keep,Improper Rec. Scrap Proc. | 415-A9BFld/Keep,Improper Rec.Veh.Rebuilder | 415-A8BFld/Leave Suff Space/Combin Of Vehs | 1129-BFld/Make Required Invest Employees | 509-DFld/Make Required Invest. Employees | 509-D1Fld/Notify Dmv Change Of Address | 509-8Fld/Notify Insurer/Acc F.H. Veh (Misd) | 370-4Fld/Require Oper.File List/Vio Rec. | 509-FFld /Stop @ Railroad Crossing Sign | 1685Fld/Stop @ Yld Sign When Required | 1172-BFld/Stp Frm Ally/Drwy/Privrd As Req | 1173Fld/Surr/Lic/Reg Plates/Rev-Art7 (Misd) | 340-AFld/Surrender Susp/Revoked/Lic Reg | 510-7Fld To Deliver Plates/Repo.Vehicle | 425-2Fld To Destroy/Deliver Vin Plate (Misd) | 429-3Fld To Disclose Info/Security Agreement | 2122Fld To Execute Release/Security Interest | 2121Fld To Give Notice Of Repossession | 425-1Fld To Negotiate Rr Crossing/Insuff Clearance | 1171-A1Fld To Notfy Police/Dmv Of Los/Theft Of Deal Plate | 415-15Fld To Obey Traffic Signal Ahead | 1111-EFld To Post Sign Re: Insurance Law | 398-D4AFld To Provide Cert Prior Use Taxi Rental Police | 417-A1AFld To Remove Debris From Hgwy | 1219-CFld To Report Conv/Bail Forfeit Or Fld To Appear | 514-7Fld To Stop At Railroad Crossing | 1170-AFld To Stop On A Steady Red Arrow | 1111-D3Fld To Stop @ Railroad Crossing - Certain Vehicles | 1171-AFld To Stop School Bus | 1174-AFld To Stop @ Stop Sign | 1172-AFld To Turn As Required | 1160-DFld To Use Due Care Bycl/Ped/Animal | 1146Fld To Use Due Care Bycl/Ped/Animal | 1146-AFld To Use/Improper Use-4-Way Flash | 1163-EFld To Yld Rt-Of-Way @ Intersection | 1140-AFld To Yld Rt-Of-Way On Left Turn | 1141Fld To Yld Rt-Of-Way @ Stop Sign | 1142-AFld To Yld Rt-Of-Way To Pedestrian In Crosswalk | 1151-AFld To Yld Rt-Of-Way To Veh On Rght | 1140-BFld To Yld Rt-Of-Way @ Yld Sign | 1142-BFld/Written Est/Charged Excess | 398-D2Fld Yld Rt-Of-Way/Lft Trn @ Rd Sig | 1111-D2BFld Yld Rt-Of-Way/Rt Trn @ Rd Sig | 1111-D2AFld/Yld Rt-Of-Way To Blind Person | 1153-AFld/Yld Rt-Of-Way To Emerg Vehicle | 1144-AFld/Yld Rt-Of-Way @ Traf Crcle/Isl | 1145Fld/Yld Rt-Of-Way When Enterg Rdwy | 1143Following Fire Apparatus | 1217-FFollowing Too Closely | 1129-AForging Proof Of Insurance | 356Front Seat Pass Age 4-7 No/Impropr Restraint | 1229-C2CFront Seat Pass Age 8-15 No/Impropr Seatbelt | 1229-C2AFront Seat Pass Less Than 4 No/Imp Restraint | 1229-C2BHandicapped Parking | 1203-B2Hands Not On Handlebars- Mcy | 1251-CHeavy Vehicle Exceeding Emissions | 301-B1Holding More Than 1 Nys License | 509-5Illegal Back Frozen Dessert Truck | 1211-CIllegal Labeling Of Brake Fluid | 382-2Illegal Sales From Frozen Dessert Truck | 1225-B1Improper Charge/Filing Security Interest | 2125-CImproper Entrance/Exit Of Controlled Access Hwy | 1130-2Improper /Fld To Keep Records | 398-D3Improper Hand Signal | 1165Improper Handlebars- Motorcycle | 381-5Improper Left Turn On One-Way Rdwy | 1160-CImproper Left Turn On Two-Way Rdwy | 1160-BImproper Left Turn-One-Way Rdwy | 1166-CImproper Left Turn-Two-Way Rdwy | 1166-BImproper/No Lights Atv | 2406-1EImproper/No Signal | 1163-DImproper Operation Of Bicycle | 1232-AImproper Or Unsafe Turn/Without Signal | 1163-AImproper Passing | 1123Improper Passing-Motorcycle | 1252-BImproper Plates | 402-4Improper Plates Motorcycle | 411-3Improper Right Turn | 1166-AImproper Rt Turn Intersection | 1160-AImproper Safety Belts(School Bus) | 383-5AImproper Sale/Junk Car (Misd) | 429-2CImproper Service Brake System | 382-BImproper U Turn | 1160-EImproper U-Turn At Grade/Curve | 1161-AImproper U-Turn In A School Zone | 1161-BImproper Use/Agrigultural Truck | 401-7E2Improper Use Farm Plates 8/30/85 | 401-13Improper Use Of White Cane | 1153-BImprudent Speed Approaching Horse | 1146-A2Inad/Altrd/No Modified Exhst Sys Mcy | 381-11Inad. Lights/Auth. Emer. Veh. | 2406-3CInadequate Brakes | 2406-1AInadequate Brakes-Motorcycle | 381-1AInadequate Brakes - Motorcycle | 381-1ABInadequate Muffler | 2406-1BInadequate/No Reflector- Motorcycle | 381-4Inadequate/No Safety Belts | 383-1Inadequate/No Spark Arrester | 2406-1CIndequate/No Occ. Compartment Prot. | 382-CInsuff Lights On Veh Carrying People | 1223Insuff Turn Sig - Less Than 100' | 1163-BInsufficient Lights/Nohorn - Motorcycle | 381-1AEInter'D W/Driv View Or Control-Pass | 1213-BInterfered W/Cycle Oper.View | 1251-DInterfered W/ Safe Operation | 1124Interfered W/Use Of Lane - Mcy | 1252-AInterfered With Fire Apparatus | 1217-ILap/Shoulder Violation Or Dj Violation | 1229-C3ALeave Scene Accident W/O Report Atv | 2413-2Leaving/Scene Property Damage Acc. | 600-1ALeft Pavement To Pass On Right | 1123-BLiability Insurance | 25.13 (PRL)Lighting Vio Vehicle & Trailers | 376-1ALimited Use Veh Driven In Unauth Area | 2262-3Logs Insecurely Fastened | 377-1LMisuse Of Dealer Plates | 2283-3Misuse Of Dealer/Transporter Plates | 415-8More-One State Lic | 509-10More Than Two Abreast-Bicycle | 1234-BMotor Carrier Allow/Require Driver To Use Handheld Mobi | 1225-C2DMotor Carrier Allow/Require Driver To Use Portable Elec | 1225-D1AMotor Carrier Failed To Furnish Rec | 509-NMotor Vehicle Plate Violation - Dealer | 415-9BMoved From Lane Unsafely | 1128-ANo 18 Or Over In Auto/Truck | 1222-2No Bell Or Signal Device On Bicycle | 1236-BNo Child Bicycle Helmet | 1238No Distinctive Plate/Insecure/Dirty | 402-1No/Failed To Use Signal Lamps | 1164-BNo Handicapped Zone Provided | 1203-C1No Hands On Wheel Or Steering Devic | 1226No Helmet Atv | 2406-2No/Improper Invoice/Fld Part Avail | 398-D1No/Improper Records - Dealer | 2267-3No/Improper Reflector-Bicycle | 1236-ENo/Inadequate Brakes-Bicycle | 1236-CNo/Inadequate Lights-Bicycle | 1236-ANo/Inadequate Plate Lamps | 375 - 2(a)4No License/Instructor Certificate | 394-8ANo/More Than One Sticker | 403-1No Motorcycle Plate | 411-1No Notice-Junked Veh.- All Others (Misd) | 429-1CNo Notice-Junked Veh.- Dealer (Misd) | 429-1BNo Notice-Junked Veh.- Ins.Co. (Misd) | 429-1ANo Oper Unless Racks Secure | 1222-1BNo Oper Unless Seats Secure | 1222-1ANo Oper Unless Tailgate Secure | 1222-1CNo Operable Headlamps | 376-A2No Overweight/ Size Permit | 385-15No Rearview Mirror Mtcy | 381-10No Red Flags/Amber Lights (Farm) | 385-1BNo Reflector Wheel/Bicycle | 1236-DNo Reg Unless Inspected | 306-CNo Safety-Belt Front Seat-1965 | 383-1ANo Safety-Belt Pass- 1967 | 383-1BNo Safety-Belt Seat Position- 1968 | 383-1CNo Safety Chain | 377-1SNo Seat Belt | 1229-C3No Stopping/Standing/Parking On Highway | 1201-ANo Us Mail Sign | 1229-1Non-Driver Ident/Change Of Address | 492-3Not Seated Properly-Motorcycle | 1251-BObstructing Intersection | 1175Obstructing Railroad Crossing | 1176Obstructing Railroad Crossing-Commercial | 1176-COccupy State Hgwy Selling/Solicitng | 1157-COffer/Sells License/Reg/Plates (Misd) | 392-AOp Mv- Mobile Phone | 1225-C2AOpened Door Unsafely | 1214Oper. 100 Feet Dwelling | 2404-1GOper Camp/Charter Bus W/ Standees/10 Miles Or More | 1229-B1Oper Cmv No Med Cert | 509-7AOper Escort Veh In Viol Of Dot R&R | 551-3Oper. Frozen Public Waters | 2404-1FOper Has More Than 1 Pass Under 21/Dj/Mj/Permit | 501-B1COper Has Pass W/No Seatblt/Child Rest-Dj/Mj/Lic | 501-B2AOper In Vio/Of Cond License | 1196-7FOper Mv While Using Portable Elec Dev | 1225-DOper Nonsupv Front Seat Occupnt-Dj/Mj/Permit | 501-B1AOper/Permit Oper/Lic/Reg Rev -Art 7 (Misd) | 355Oper/Permit Oper/Uninsured F.H. Veh (Misd) | 370-2Oper/Permit Oper W/Ability Impared | 509-KOper School Bus Childrn Under 4 W/O Prop Restraint | 1229-C11Oper W/Pass No Seatblt/Child Rest-Dj/Mj/Perm | 501-B1BOper Within 4 Hours Consuming Alch. | 509-L1AOperat W/O Filing Notice/Disability | 509-9Operate Mcy. Illeg. Exh. Dev. | 381-12Operating Out Of Class | 509-2Operating School Bus When Passengers Are Standing | 1229-B2Operating Upon Bridge When Access Is Forbidden | 1629-3Operating/Violation Of Restrictions | 509-3Operating While Registration Susp/Revoked | 512Operating Without Insurance | 319-1UOperation In Tree Nursery | 2404-1DOperation On Private Prop. W/Out Consent | 2403-3Operator Has More Than 1 Pass Under 21/Dj/Mj/Lic | 501-B2BOther/Studs On Highway | 2406-3AOther Use Of License | 509-6POverheight Vehicle | 385-2Overlength Altered Livery Vehicle | 385-3FOverlength Bus- 45 Feet | 385-3COverlength Semi- 48 Feet | 385-3BOverlength Vehicle | 385-3EOverlength Vehicle-Combination | 385-4AOverlength Vehicle- Single Vehicle | 385-3AOverload/ Metal Tires | 385-12Overload On Axle | 385-8Overload On Consecutive Axles | 385-9Overload On Tires | 385-6Overload On Wheels | 385-7Overload/ Solid Rubber Tires | 385-11Overload State/Municipal Equipment | 385-17AOverweight Exceed Gross Weight Allowed | 385-10Overweight Fire Vehicle | 385-17BOverweight On Reg. Certain Trailers | 401-8DOverweight On Reg. Combination | 401-8COverweight On Reg. Single Vehicle | 401-7FBOverwidth Vehicle | 385-1AParking Fire Area | 1217-PParking In Off Street Handicapped Zone | 1203-C4Passed Flashing Red Light | 1113-APassed On Right | 1122-APassed Red Signal | 1111-D1Passed Stopped Vehicle @ Intersect Or Crosswalk | 1151-CPed Crossed Against Yw Signal | 1111-B3Ped Crossed Red Signal | 1111-D4Ped Fld To Use Right Half Of Crosswalk | 1155Ped Fld To Use Sidewalk | 1156-APed Fld To Walk Facing Traffic | 1156-BPed Fld/Yld Rt-Of-Way Oth Than Xwlk | 1152-APed Fld Yld Rt/Way @ Tunl/Ovrhd X'G | 1152-BPed. On State Express. Prohibited | 1229-AAPed Proceeded Into Path Of Vehicle | 1151-BPed X'Ing Intersect Diag/Jay Wak'G | 1152-CPedestrian Control Signal Violation | 1112Pedestrian Started On Flashing 'Don'T Walk' | 1112-BPedestrian Started On Steady 'Don'T Walk' | 1112-CPermit Oper. Viol. Art. 48C (Owner) | 2410-5Permit Oper. Viol. Art. 48C (Parent Or Guardian) | 2410-4Permit/Req Oper/Remain On Dutyintox | 509-L2BPermit/Require Driver/Violate Prov. | 509-L2APermit Unqualified Oper/Oper Bus | 509-HPermit Unreg. Oper. By Minor | 2288Permit Use In Vio./Prov Sec 402 | 402-6Permiting Unlicensed Operation | 509-4Permits Clinging To Motor Vehicle | 1233-3Permitted Vio. Of Articles/Bic | 1230-APermitting Illegal Use/Title | 2130-B1Permitting Improper Use/Deal Plates | 2264-4Permitting Improper Use/ Plates Mcy | 411-4Permitting Operation Without Insurance | 319-1PPermitting Uninsured Oper. | 2407-4Permitting Use Of Improper Plates | 402-5Permitting Violation Of Article 34 - B | 1260Plates Not Issued By Comm | 402-2Plates Not Issued By Comm.- Mcy | 411-2Possess Alch. On Duty Operating Bus | 509-L1CProceed W/Out Caution/Flashing Ylw | 1113-BProviding Invalid Ins. Id Card (Misd) | 319-2Pull/Tow Non-Rigid Connection | 2404-1EPurchase By Scrap Processor/Veh Or Major Component | 415-A14Reckless Driving Atv | 2404-1BRent/Lease/Loan Veh W/O Interlock Prsn W Intlk Res | 1198-7BRide/No Permanent Seat | 2404-4Ride Sled W/O Rigid Connect. | 2404-3Riding In House Coach Trailer | 1228Riding Motorcycle Between Lanes | 1252-CRiding Mtrcycle More Than 2 Abreast | 1252-DRr Tracks Or Right-Of-Way | 2404-1CSafety Belt Violation - Anchor Assmbly | 383-2Sale/Illegal Brake Fluid (Misd) | 382-1Sale Of Improperly Equip. Atv | 2282-6BSale Of Unapproved Headlighting Dev (Misd) | 375-7Sale Of Unapproved Safety Belts | 383-3Sale/Unapproved Brake Linings | 382-ASale/Unapproved Brake Linings | 382-A1Sale/Unapproved Helmet,Goggles Etc. | 381-9Sale/Unapproved Traf Control Dev | 1680-DSchool Bus/With Passengers/Right On Red | 1111-D5Snowmobile Violation - Ill Reg Number | 2223-1Solicited Ride/Business | 1157-ASolicited Watching/Guarding Vehicle | 1157-BSounded Horn Approaching Horse | 1146-A3Speed In School Zone - Junior | 1180-CJSpeed In Zone 1-19 mph over | 1180-D(1)Speed In Zone 20-24 mph over | 1180-D(2)Speed In Zone 25-29 mph over | 1180-B(3)Speed In Zone 25-29 mph over | 1180-D(3)Speed In Zone 30-34 mph over (Thruway Only) | 1180-B(4)Speed In Zone 30-34 mph over (Thruway Only) | 1180-D(4)Speed In Zone - Junior | 1180-DJSpeed Not Reasonable & Prudent | 1180-ASpeed Not Reasonable & Prudent | 2404-1ASpeed Over 55 Zone 1-19 mph over | 1180-B(1)Speed Over 55 Zone 20-24 mph over | 1180-B(2)Speed Over 55 Zone - Junior | 1180-BJSpeed W/Radar Detector/Etc/Special Veh | 1180-GASpeed W/Radar Detector Veh Over 18,000 | 1180-GISpeed W/Radar Detector Vehicle Over 18,000 Gvw | 1180-GSpeeding In Posted Work Zone | 1180-FSpeeding In School Zone | 1180-CSpeeding On Restricted Highway | 1180-D2Switched Trailer Plates | 401-1BTamper W/Official Traf Cont Devices | 1115-ATaxi Belt Not Usable | 383-4BThrew/Deposited Glass, Etc On Hgwy | 1219-AThrew/Deposited Refuse/Etc Hgwy | 1220-AToo Many Riders - Bicycle | 1232-BTowing Agency Fld To Notify Police Of Veh Removal | 1210-CTransp Vehicles Out Of Nys W/Out Displaying Number | 415-A12BTravel In Lane Cont'D By Red Signal | 1116-DTwo On Seat For One-Motorcycle | 1251-AUnapproved Lights- Motorcycle | 381-2Unapproved Lights/Signals | 376-3Unapproved/No Face Shield- Mcy | 381-7Unapproved/No Protective Helmet Mcy | 381-6Unapproved/No Windscreen- Mcy | 381-8Unattended Vehicle | 1210-AUnauth. Fed/St/Mun Shield/Lettering | 396-1Unauth Fire Dept/Shield/Seal Letter | 396-3Unauth Police Receiver/ Private Veh | 397Unauth Police Shield/Seal Lettering | 396-2Unauth. Use Red/White Lights | 2406-3BUnauthorized Lights- Motorcycle | 381-3Unauthorized Removal Of Tag/Sticker | 403-1RUncertified Scrap Collector | 415-A10AUncertified Scrap Processor | 415-A9AUnd. 16/Unsup. No Certificate | 2410-1Uninspected Heavy Vehicle | 301-B2Uninsured Atv | 2265-3Unlaw Dispos Summons | 207-5Unlaw Trans/Nondriver Id | 495Unlawful Commercial Towing | 401-BUnlawful Oper On Highway Atv | 2403-1Unlawful Oper. Public Lands | 2403-2Unlawful Solicitation Of Ground Transp At Airport | 1220-BUnlawful Solicitation Of Ground Transp At Airport | 1220-B1Unlawful Validation Device | 392-4Unlic Service Bureau | 395Unlicensed Operation Of A For Hire Vechile | 509-12Unlicensed Operator | 509-1Unreasonable Speed/Special Hazards | 1180-EUnreg. Dealer Limited Use Veh. | 2267-1Unreg Snowmmobile | 2222-1Unregistered Atv | 2282-1Unregistered Dealer | 415-3Unregistered Dealer (Atv) | 2282-6AUnregistered Itinerant Vehicle Collector | 415-A1CUnregistered Limited Use Vehicle | 2261-1Unregistered Mobile Car Crusher | 415-A1BUnregistered Motor Vehicle | 401-1AUnregistered Motorcycle | 410-1Unregistered Repair Shop | 398-C1Unregistered Salvage Pool | 415-A1AUnregistered Trailer | 402-3Unregistered Vehicle Dismantler | 415-A1Unregistered Vessel | 2251-1Unsafe Starting | 1162Unsafe Tires Atv | 2406-1DUse/Loaned Dealer Plates More 5 Day | 416Use Of Radar Detector - Vehicle Over 18,000 | 397-A1Use Rented/Leased/Loaned Veh W/O Interlock | 1198-7AUsing License | 509-6UVehicle Not Under Control On Mountain Highway | 1215-UViolation Impoundment Procdures | 318-12Violation Of Restricted License | 530-6Working On State Hgwy W/O Permit | 1220-AWWorking On State Hgwy W/O Permit | 1220-C***Please note that any violation not listed above is NOT eligible for the Traffic Diversion Program. Please contact the court listed on the citation for information on how to resolve it. If your client received a violation for 306-(B) Uninspected Motor Vehicle or an equipment violation containing code 375, these violations are not eligible for the Traffic Diversion Program. Instead, please send an email with the citation and proof of inspection/repair to the Madison County District Attorney's Office at traffictickets@madisoncounty.ny.gov Was there an accident?* Yes No Violation Fees Court Location*Please select the Court Location as indicated on your client's traffic citation (see the GREEN circle on the sample ticket above). Town of BROOKFIELD Village of CANASTOTA Town of CAZENOVIA Village of CAZENOVIA Village of CHITTENANGO Town of DeRUYTER Village of EARLVILLE Town of EATON Town of FENNER Town of GEORGETOWN Town of HAMILTON Village of HAMILTON Town of LEBANON Town of LENOX Town of LINCOLN Town of MADISON Village of MORRISVILLE Town of NELSON City of ONEIDA Town of SMITHFIELD Town of STOCKBRIDGE Town of SULLIVAN State (or Province) of Registration of the vehicle involved in the infraction*Use abbreviations only -- e.g., NY, PA, OH, ON License Plate number of the vehicle your client was driving when the infraction(s) took place* Attach a photograph or scan of your client's citation(s).*If your client received more than one citation, upload a copy of each ticket separately. This will ensure faster processing of your client's Diversion Program registration. You can upload multiple files. IMPORTANT: it may take a moment for the file(s) to upload.Please wait until you see the name(s) of each of the file(s) that you uploaded listed below BEFORE you move to the next question. You can delete a file by clicking the button next to the file name. If you need help with uploading the citations, please click here. This will open a new window and you will not lose your place on this form. Drop files here or Select files Accepted file types: jpg, gif, png, pdf, jpeg, Max. file size: 128 MB. Upload an indemnification letter from your client's insurance carrier.*Our office will need a letter from your client's insurance company stating they have active coverage and any relevant property/personal injury damages have been paid in full. IMPORTANT: it may take a moment for the file(s) to upload. Please wait until you see the name(s) of each of the file(s) that you uploaded listed below BEFORE you move to the next question. You can delete a file by clicking the button next to the file name.Accepted file types: jpg, gif, png, pdf, jpeg, Max. file size: 128 MB.Today's Date* MM slash DD slash YYYY By signing this form, you acknowledge that you and your client have read and understood the following Violator's Rights: You have the right to have your client's violation(s) addressed through the court system. You have the right to have your client's violation(s) reviewed by a judge. Your client also has the right to have an attorney represent him/her and the court may determine that your client is eligible for a free attorney if he/she cannot afford one. If your client chooses to go to court, the client and their attorney have the right to discovery of records involved as well. If you register for the Diversion Program on behalf of your client and he/she is approved, your client will not need to attend court and your client's penalties will be far less than if found guilty. This is possible because this program is not about punishment, but rather public safety and respect. This program is designed to make our community safer for everyone. In order for the program to work, however, your client must, if accepted, waive all claims to a speedy trial and discovery. When accepted into the program, you will receive a notification and the District Attorney’s Office will advise the court to adjourn your client's case. You and the court will receive notification that the Madison County District Attorney’s Office is withdrawing the violations pending against your client. The Registration Form has the following language which you must sign on behalf of your client: I hereby understand that by registering my client as a participant in the Madison County Traffic Diversion Program, my client is waiving their right to a speedy trial, pursuant to Article 30 of the Criminal Procedure Law and that we will not receive any further discovery to which we are entitled pursuant to Article 245 of the Criminal Procedure Law, I am hereby requesting an adjournment of the case. I agree that failure to respond to the information sought or the giving of false or incorrect information on this registration form is grounds to deny my client Diversion or remove my client from the program. I acknowledge that I understand that it is a crime punishable as a Class A Misdemeanor under the laws of New York for a person in and by a written instrument to knowingly make a false statement or to make a statement, which such person does not believe is true and pledge that I have not done so on the Registration Form. Warning: If you have not received a notice by email or any other form of communication from the District Attorney’s office that your client's Traffic Diversion registration was approved, your client must appear at the date and time indicated. Failure to do so will result in the suspension of your client's license and other possible sanctions. Your client will lose the registration fee paid. If you have any questions, please contact our Help Desk at 866.250.6050. AFFIRMED UNDER PENALTY OF PERJURY The starting fees for the Madison County Traffic Diversion Program range between $100 and $500, depending upon the infraction cited. Additional citations received at the same traffic stop will add an additional $25 per violation. The total amount your client owes has been calculated for you and is displayed at the bottom of this page. After you complete the credit card/debit card data entry, a nominal service fee will be added on as well. By signing your name below (with a mouse on a computer, or with your finger on a touchscreen or mobile device), you acknowledge that you have read and understand your client's rights as listed above.Registrant's Signature* Reset signature Signature locked. Reset to sign again Please sign your name with a mouse on a computer, or with your finger on a touchscreen or mobile device.Credit CardDO NOT ENTER SPACES OR DASHES BETWEEN NUMBERS. DiscoverMasterCardVisaSupported Credit Cards: Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Expiration Date Security Code Cardholder Name Base Price Price: Administrative Fee Price: Card Processing Fee Price: Total $0.00 NameThis field is for validation purposes and should be left unchanged. Need Help? Call us at 866.250.6050 Email us at help@DiversionConnect.com Our Diversion experts are available between 9:00am and 5:00pm weekdays to answer your calls. Important Links Register for the Diversion Program Upload your Completion Certificate How to Scan and Upload a Ticket or Certificate Crime Victim’s Rights Violator’s Rights Find a Defensive Driving Course