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									                                     JUDGE H. BLANCHETTE
                                    Justice of the Peace, Pct.2
                                     1000 N. Byrd Ave. Ste.5
                                       Shepherd, TX 77371
                                            (936) 628-6477
                                          (936) 628-3953 Fax

THE STATE OF TEXAS                                §       IN THE JUSTICE COURT

VS.                                               §       PRECINCT TWO

____________________________________              §       SAN JACINTO COUNTY, TEXAS

                                DEFERRED DISPOSITION REQUEST
                                 CAUSE NUMBER________________

To the Honorable Judge of said Court,

I, ___________________________________, Defendant in the above styled and numbered cause,
hereby enter my plea of Guilty/Nolo contendere, and request deferred disposition of the offense of:
___________________________________. I understand that my deferral period will be for 30 days and
if I comply with the following conditions my ticket will be dismissed under the authority of Article
45.051, Texas Code of Criminal Procedure:

Conditions of Deferred Disposition:
1.     I shall pay a special expense fee of $290.00.
2.     I shall not be convicted of any moving violation within the 30 day deferral period.


1.     I DO NOT have a Commercial Driver's License (Commercial driver's license holders will not be
2.     I was not going 30 mph or more over the posted speed limit.

I pray that the above motion for Deferred Disposition be granted.

Defendant's signature

On this ______day of _____________________, 200___ the above named person appeared and swore
an affidavit under oath that the above information set out herein is true and correct.

Judge / Clerk / Notary Public

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