Barker Richardson, PLLC
"Little Firm, Big Results."
Speeding Ticket Intake Form
Your Full Name, EXACTLY as it appears on your citation:

Your Email Address:

Please Confirm Your Email Address:

Your Telephone Number:

County Where You Were Charged:

Your Citation Number:

Date You Were Charged:

Your First Court Date:

Posted Speed Limit Zone: (ex: 55 mph)

Charged Speed: (ex: 67 mph)

Tell us what happened:

You are the person charged in the citation, have read and agreed to our terms of use and you are over the age of 18 years?



Please describe anything else you want us to consider in your defense:

Please tell us about your Driving Record (MVR) in the last three (3) years, in all jurisdictions. After we are retained, we will obtain a copy of your driving record to review.

Driver License State and Number: (ex: NC1234567)

Date of Birth

Enter the numbers from the image:



          
919-831-8901
318 South McDowell Street, Raleigh, NORTH CAROLINA, 27601, United States
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