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PLC:

4277

Agency:

incorporated village of laurel hollow

For:

fines & surcharges - judge ligas-hadjandreas

Phone:

516-692-8826

Address:

1492 laurel hollow rd
syosset, new york 11791

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*Defendant Name:

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*Last:

*Date of Birth:

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*Ticket #:

*Ticket Issue Date:

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*Case #:

*Phone #:

(### - ### - ####)

*Email:

*I plead guilty to this charge and I acknowledge that a plea of guilty is equivalent to a conviction after trial:

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*If convicted, not only will I be liable to a penalty, but in addition my license to drive a motor vehicle, or motorcycle, and my certificate of registration, if any, are subject to suspension and revocation as prescribed by law.:

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*Conviction may subject me to a mandatory surcharge and/or Driver Responsibility Assessment as prescribed by law.:

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*Last Name:

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*City:

*State/Province:

*Zip:

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*Credit/Debit Card:

(enter the full card number without any dashes or spaces)

*Expiration Date:

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