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DIANE M. MATOUSEK CLERK OF THE CIRCUIT COURT VOLUSIA COUNTY, FLORIDA

Citation No._________________ Statute No._____________________ Name _____________________________________________________Pursuant to Florida Statute 318.14(9), if you have received a traffic citation for an infraction that does not require a mandatory hearing and you do not currently hold a CDL license, you may elect tocomplete a defensive driving school. Upon completion of the school, the Clerk of Court will withhold adjudication of guilt and no points will be assessed against your driving record. School must becompleted and completion certificate filed with the Clerk by the date sworn/subscribed. TO BE ELIGIBLE FOR THE SCHOOL OPTION: 1. 365 days must have passed since you last signed an affidavit to attend theDefensive Driving School. 2. Attend an approved school within the State of Florida. 3. You have not taken this option five (5) times in a lifetime. 4. You do not currently hold a CDL license. 5. Pay afine and court costs in the amount of __________________. 6. Attend the Defensive Driving School and provide proof of completion to the Clerk’s Office in the county you received the citation within 60days. FAILURE TO COMPLETE THE SCHOOL IN TIME WILL RESULT IN: 1. Drivers license will be suspended by the State of Florida. 2. Pay a late fee of $23.00, an $18.00 service charge, and possibly adrivers license reinstatement fee. 3. Forfeit one of your elections. 4. Adjudication of guilt and points will be assessed on your driving record. 5. Forfeit all court costs paid. ELECTING THE SCHOOL OPTIONWHEN NOT ELIGIBLE: (Notification by Dept. Highway Safety & Motor Vehicles) 1. Drivers License will be suspended by the State of Florida. 2. Pay a late fee of $23.00, an $18.00 service charge, andpossibly a drivers license reinstatement fee. 3. Adjudication of guilt and points will be assessed on your driving record. AFFIDAVIT I, hereby swear or affirm that I am eligible for the option of...