Reassignment Request

Please fill out the following form to request an extension for cases held with the 19th Judicial District Court Traffic Division. Once completed, a member of the 19th Judicial District Court will contact you within 3 business days to provide you with a new Court date. Please be advised, the Court will send you notice of your new Court date via the email address provided.

Name

First Name

Last Name

Date of Birth

YYYY

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Case Number or Ticket Number

Scheduled Court Date

YYYY

Phone Number

(###)

###

####

Reason for Request

Are you in the process of getting your driver's license reinstated?

Yes