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2. 
4. Name (last, first, middle initial)
6. Mailing Address (where you will receive your notice for trial)
8. City
9. State
10. Zip Code
12. Email Address
13. Phone Number
15. Warrant/Citation number(s) (include all numbers & letters)
17. Charge(s)
19. Court date
21. I hereby request a continuance for the following reason:
23. All continuance requests must be filled in a timely manner prior to your court date. It is your responsibility to complete this form in its entirety. Submitting the request does not automatically mean a continuance is granted. You are responsible for ensuring the request is received and/or answered. Failure to do so may result in you being tried in your absence.
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27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

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