Forms - Make a payment - Pre-Trial Diversion Payments - CCDA

“Use this form only ONLY if you wish to amend your PTD contract to give a donation in lieu of completing your mandatory community service hours. You will need to be in compliance with your PTD contract or have approval from the DA’s Office.”

Contract Payments - Amended Pre-Trial Diversion

Email Address Used to contact you in case of problem with payment

Case Number Court assigned case number

Probation Officer Name of probation officer approving community service buy-out

Defendant’s First Name

Defendant’s Last Name

Defendant’s Date of Birth Ex: 01/15/1990

Defendant’s Address Line 1

Defendant’s Address Line 2

City

State

Zip

Defendant’s Phone Number

Defendant’s Email Address

Payment method

Payment Details

Payment amount

Convenience Fee (Credit Card) 5.00% (of subtotal)

Note: a minimum charge of $1.00 will be applied.

Total

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956-544-0849