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Driver/Vehicle Owner and Notice of Violation Information (NOV) (To be provided by requestor)Date: _____Name (Typed or Printed): _____Mailing Address: _____ _____City: _____ State: _____ Zip: _____Telephone Number: _____ Fax: _____E-mail: _____NOV Number: _____NOV Violation Date: _____Agency/Issuing Authority: Jacksonville Sheriff's Office Issuing Officer/Agent Name: _____Badge #: _____Local Court or Hearing Officer Information (To be provided by local authority)Mail to: City Of Jacksonville Traffic Safety ProgramHearing location: TBDKeep a copy of this request for your records**THIS PAGE OF THE DOCUMENT MUST BE INCLUDED WITH THE AFFIDAVIT ON THE NEXT PAGE!**CITY OF JACKSONVILLE TRAFFIC SAFETY PROGRAMREQUEST FOR LOCAL HEARINGRED LIGHT VIOLATIONA ffidavit Requesting Hearing and Forfeiting Ability to Contest DeliveryI (Name) do hereby request a formal hearing before a local court or hearing officer in the county of Duval County.
Affidavit Requesting Hearing and Forfeiting Ability to Contest Delivery I (Name) do hereby request a formal hearing
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