Ticket Number: AB181427 - 1900

SUPERIOR COURT OF CALIFORNIA, COUNTY OF LOS ANGELES FOR COURT USE ONLY
ADDRESS: 42011 4th Street West
CITY AND ZIP CODE: Lancaster, CA 93534 Electronically
BRANCH NAME: Michael Antonovich Antelope Valley Courthouse
PEOPLE OF THE STATE OF CALIFORNIA FILED
By Superior Court of California
VS. County of Los Angeles
DEFENDANT: IRENE PADILLA
AGREEMENT TO FORFEIT BAIL IN INSTALLMENTS
04/26/2018
SHERRI R. CARTER, CLERK
(Vehicle Code § 40510.5)
TICKET NUMBER
AB181427 - 1900
1. I am the defendant in the case and I have been charged with the following infraction violation(s) of the Vehicle
Code that does not require me to appear in court.
22349A 29
a. § _________________ b. § _________________ c. § d. § _________________

2. My court appearance date has not passed.

3. I want to pay and forfeit bail for the violation(s) listed above.
4. I understand that by signing below each reportable violation will be reported to the Department of Motor
Vehicles as a conviction.

5. TERMS OF AGREEMENT:
The total bail including penalties is: $ 238.00 Initial Payment (10% minimum or more - VC § 40510.5): $ 23.00
Remaining balance after the first payment: $ 215.00
One-time Administrative Fee (due forthwith): $ 35.00
Online Transaction Fee (if applicable): $ 5.00
Total amount due today: $ 63.00

I agree to pay the balance due in monthly installments of at least ____________

50.00 due each month, starting
____________
04/26/2018 and to have the balance paid in full on or before 09/26/2018
___________ .

I agree that:
 All payments must be made by the due date and there is no grace period.
 If I do not make a payment on time, I may have to pay the rest of my unpaid bail immediately.

I understand that if I fail to complete my payment plan the Court may:

 Civil assessment of $300 pursuant to Penal Code Section 1214.1 will be added to the balance.
 The court may assign my case to a collection agency.

I understand that if I pay as agreed my bail forfeiture will be complete and the case closed.
✔ By signing I declare that I have read and understand my rights, which I now choose to give up, and that I have read, understand, and agree
to the terms and conditions stated above. (See Attachment I)

✔ By selecting this box, I declare that I have read and understand the Electronic Communications Consent Agreement and I certify that I am
signing this agreement electronically. (See Attachment II)

IRENE PADILLA B9482404

(Signature of Defendant) (Name) (Driver’s License/ID Number)
700 W AVE I J203 LANCASTER, CA 935341969 (323) 304-9454
(Address) (City, State and Zip Code) (Telephone Number)
✔ By checking this box, I declare that I have read and understand the terms and conditions
described above. (See Attachment III) (optional)
padilla_irene@yahoo.com
(Email Address)

04/26/2018
Accepted (Date):________________ Sherri R. Carter
By: ___________________________, Clerk of the Superior Court

LASC (Rev.5/15) AGREEMENT TO FORFEIT BAIL IN INSTALLMENTS Veh.Code §40510.5

MANDATORY (Traffic Infractions) www.LACourt.org

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 Ticket Number: AB181427 - 1900

Payment Plan Schedule

* Fees are excluded from the payment plan schedule and are charged separately

No. Payment Date Beginning Balance Payment Ending Balance

1 04/26/2018 $238.00 $23.00 $215.00
2 05/26/2018 $215.00 $50.00 $165.00
3 06/26/2018 $165.00 $50.00 $115.00
4 07/26/2018 $115.00 $50.00 $65.00
5 08/26/2018 $65.00 $50.00 $15.00
6 09/26/2018 $15.00 $15.00 $0.00

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 Ticket Number: AB181427 - 1900
Attachment I

ADVISEMENT OF RIGHTS

By choosing to pay and forfeit bail in installments and not go into court, you will be giving up these
rights:

 To appear in court for formal arraignment, plea, and sentencing;

 To have a court trial and challenge the charges;

 To have a speedy court trial and have the charges dismissed if a speedy trial is requested but not
provided;

 To be represented by an attorney at your expense;

 To subpoena or present witnesses and physical evidence using the power of the court at no cost
to you and to testify on your behalf;

 To confront and cross-examine all witnesses testifying against you under oath; and

 To remain silent and not testify.

PAYMENT OPTIONS

INTERNET: www.LACourt.org
AUTOMATED TELEPHONE: Visit www.LACourt.org for your area phone number

Alternative Payment Option:

Make checks payable to Los Angeles Superior Court and clearly write the citation number on the check.
Send to the address listed at the top of your installment agreement.

Revised 6/1/2015
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 Ticket Number: AB181427 - 1900

Attachment II

SUPERIOR COURT OF CALIFORNIA, COUNTY OF LOS ANGELES

CONSENT AND NOTICE REGARDING ELECTRONIC COMMUNICATIONS

Electronic signature agreement. By selecting the “I Agree” button, I declare under penalty of perjury
under the laws of the State of California that the following is true and correct. I agree that, by signing
this Agreement electronically, my digital signature is the legal equivalent of my manual signature on this
Agreement. By selecting “I Agree” I consent to be legally bound by this Agreement’s terms and
conditions. I further agree that electronically accessing or making any transaction regarding any
agreement, acknowledgement, consent terms, disclosures or conditions constitutes my signature
(hereafter referred to as “E-Signature”), acceptance and agreement as if actually signed by me in
writing. I also agree that no certification authority or other third party verification is necessary to
validate my E-Signature and that the lack of such certification or third party verification will not in any
way affect the enforceability of my E-Signature or any resulting contract between myself and the
Superior Court of California, County of Los Angeles. I further agree that each use of my E-Signature in
obtaining a Superior Court of California, County of Los Angeles service constitutes my agreement to be
bound by the terms and conditions of the Superior Court of California, County of Los Angeles Disclosures
and Agreements as they exist on the date of my E-Signature.

Revised 6/1/2015
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