Case Number Name Amount ($) 3.5% Convenience Fee($) Total to be charged($)

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Card Holder: Card Number: Card Exp Date: Receipt Email:
SwipeCard
Person Name VELAZQUEZ, MARIA -
Drivers License
State
Drivers License #
Date Of Birth 07141971
Case Number TR19-0000152
TicketNumber T5537888
Issue Date 02092019
Court Date 04112019
Offense Description 32-7A-16; FAILURE TO DISPLAY INSURANCE
Total Fine 165.00
Date Paid
Auth Num