I swear, or affirm, the following to be true:
  1. In the twelve (12) months preceding the date of this ticket, I have NOT been convicted with any moving violation anywhere in Illinois.
  2. In the four (4) years preceding the date of this ticket, I have NOT taken a 4-hour Defensive Driving class or been on Court Supervision anywhere in Illinois.
  3. My ticket was NOT marked with “Court Appearance Required.”
  4. I further understand that I DO PLEAD GUILTY to the charges on this ticket, WAIVE my right to a hearing by the court, and REQUEST court supervision.
  5. I agree to pay the non-refundable $42 Traffic Safety Program fee plus the fine indicated on the ticket. I understand that taking the class online or at another location will require an additional fee.
  6. I understand that taking the class online or at another location will require an additional fee.

I understand my driving record can be checked. If it indicates that I HAVE been convicted of a traffic offense that resulted in any of the possibilities in 1 and 2 above, MY PLEA OF GUILTY WILL BE ACCEPTED AND A CONVICTION WILL BE ENTERED AGAINST ME AND REPORTED TO THE SECRETARY OF STATE TO BE INCLUDED ON MY DRIVING RECORD.

I further understand, if I make an application for the Traffic Safety Program and I am not eligible, OR I fail to complete the Traffic Safety Program in a timely manner, OR I receive another traffic conviction within my Court Supervision period, OR I fail to pay the appropriate fine and fee, THAT A CONVICTION WILL BE ENTERED AGAINST ME AND REPORTED TO THE SECRETARY OF STATE TO BE INCLUDED ON MY DRIVING RECORD.