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PLC:

a001rq

Agency:

new scotland town court

For:

fines & fees judge wukitsch

Phone:

518-475-0493

Address:

58 verda avenue
clarksville, new york 12041

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*Defendant's Name:

Middle:

*Last:

*DOB:

(Month / Day / Year)

*Case/Ticket #:

*Contact Phone #:

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

Notes:

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Payment Amount :

Subtotal:

$0.00

Total:

$0.00

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*First Name:

Middle Initial:

*Last Name:

*Billing Address:

*City:

*State/Province:

*Zip:

*Country:

*Phone Number:

*Credit/Debit Card:

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

*Expiration Date:

*Card Security Number:

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