Request for Payment Extension Home » Departments » 15th District Court » Request for Payment Extension Page Content Ticket Number Charge First Name Middle Name Last Name Suffix Phone Number E-mail address Date of Birth Street Address Street Address Line 2 City State Zip I certify that I am the named defendant above. I enter my appearance, waive my right to a hearing and admit responsibility for the civil infraction. My explanation and reason(s) for requesting a payment extension are: (Type reason in box) The Court cannot waive points or amend charges. The judicial officer will respond to you via U.S. Mail at the address provided with a Civil Infraction Judgment form. The form will contain the amount you owe and the due date for payment. If your request is denied, you are responsible for payment on or before the current due date.