Infraction Diversion Application

Name

Phone Number

Email

Address
Street
Apt/Lot
City State
Zip

Date Of Birth

Driver's License Number

Ticket or UTT number

If you have an OUT OF STATE DRIVER'S LICENSE, you must email a certified copy of your driving record from your state's Department of Motor Vehicles to idp@co.monroe.in.us.

By checking this box and clicking the SEND button below, I hereby request permission to enter into your traffic deferral program and voluntarily furnish the following information for your use in determining my eligibility. It is my responsibility to verify this application is received by the Monroe County Prosecutor's Office.

Electronic Signature

(By electronically signing and submitting this document, you are affirming that everything stated herein is true and accurate to the best of your knowledge.)

**If our office determines that you are eligible for the deferral program, we will email (or mail) you the agreement that must be read, initialed, and signed. You must then return the completed agreement to the court along with your fee by the date listed on the IDP Agreement form you receive. Failure to do so may cause your license to be suspended.**

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