IN THE JUSTICE COURT FOR THE STATE OF OREGON
FOR THE COUNTY OF MARION
4660 Portland Rd., NE Suite 107, Salem, OR 97305
(503) 576-7200
TRAFFIC SAFETY DIVERSION APPLICATION
STATE OF OREGON v. [Please Enter Name Below]
Complaint/Summons No.: [Please Enter Name Below]
  1. I hereby apply for participation in the Traffic Safety Diversion Program.
  2. I have no convictions or diversion for any motor vehicle violation (including DUII) within the three years immediately preceding the date of this citation.
  3. I do not have a Commercial Drivers License.
  4. I have no other pending motor vehicle citations in this or any other court.
  5. There was not an accident associated with the alleged offense.
  6. The traffic violation is not a Class A violation or a No Insurance citation.
  7. This is not a Mobile Electronic Device violation.
  8. I agree to plead No Contest to the traffic violation which I am currently charged.
  9. I agree to pay the non-refundable presumptive fine for the offense which I have been charged and the traffic school fee.
  10. Payment must be received before or on your scheduled court date.
  11. I agree to attend and complete the court mandated traffic course and provide proof of completion within 90 days.
  12. I understand that if I do not comply with the conditions of my diversion, the diversion will be terminated and I will be convicted of the offense. I also understand there will be NO extensions, NO exceptions.
  13. I will keep the court advised of my current mailing address and telephone number during the 180 day diversion period.
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I agree*:
*The fine must be paid in full in order for the court to process the application.
**Please allow four business days for the court to reply with additional information.