Form fields marked with an asterisk (*) are required. Name * Please enter your full name as it appears on your CVB notice Violation Number * The Violation Number is found in the upper right hand corner of the Notice to Appear that you received. Hearing Date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20212022202320242025 Hearing Time * Hour Hour123456789101112 : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 am pm Phone Number * Email Address Current Mailing Address * Please include street, city, state and ZIP Code Confirmation * I confirm that I will appear for my scheduled hearing.
