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4. Guilderland Justice Court

   P.O. Box 339 

   Guilderland, NY 12084

   518-356-1980, ext. 2005

   
   

   Town Justices 

   Denise M. Randall          Bryan M. Clenahan       Margaret C. Tabak

   
   

    

    

   PLEA FORM

   
   

6. First Name*
7. Last Name*
9. Date of Birth*
   Date of Birth
10. Motorist/License ID #:*
12. Phone Number*
13. Email Address*
15. Address*
17. City*
18. State*
19. Zip Code*
21. Wish to Plea:*
    -- Select One --Not GuiltyGuilty
22. to the violation(s) of:*
24. Signature:*
26. Date:*
    Date:
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

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30. Submit

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