Form Center

2. Case # (Listed on the Ticket)*

   The Court must receive your statement before your scheduled court appearance date or with your initial response to the ticket. You will be notified by email or mail of the Judge's decision. If a fine is imposed, it will not be greater than the fine indicated on your ticket and will be due within 60 days, unless you request a payment plan. Any additional documentation must be emailed to the court email at court@bainbridgewa.gov.

3. I agree to submit my ticket for MITIGATION, which means I admit I committed the infraction, but would like the Court to consider reducing the fine. There will not be a hearing. I understand that if I want to CONTEST the ticket (argue that I did not commit the infraction), I cannot use this form and must schedule a court hearing. *

   1. Yes- I would like to mitigate my ticket and do not wish to contest this ticket.
5. Is this a ticket for disabled parking? If you had a valid disabled parking placard and forgot to put it up, email a copy of the placard and your disabled parking ID card. Share more details in your statement.

   1. No- this is not a ticket for disabled parking violation.
6. Is this a parking violation and you forgot to put up your employee parking pass? Email a copy of your pass. Share more details in your statement.

   1. No- I did not have an employee parking pass.
8. Is this a ticket for No Insurance? If you had insurance AT THE TIME OF THE TICKET, email proof and your ticket will be dismissed and you will be assessed a $25 administrative fee. If you obtained insurance AFTER the ticket, upload or email proof for the Judge to review. Share more details in your statement.*

   1. No- this is not a No Insurance ticket
   2. Yes- this is a No Insurance ticket. I WAS INSURED at the time of the ticket. I will email to court@bainbridgewa.gov proof of insurance showing I was insured on the date of the ticket.
   3. Yes- this is No Insurance ticket. I obtained insurance AFTER the ticket. I will submit proof to the court by email to court@bainbridgewa.gov.
   4. Yes- this is a No Insurance ticket. However, I have not obtained insurance after the ticket.
10. First Name*
11. Last Name*
13. Mailing Address*
15. City*
16. State*
17. Zip*
19. Email address*
20. Do you agree that the Judge's order may be sent to you by email?*

    1. Yes
    2. No- please mail to my mailing address
22. Phone number (in case the court clerk needs to reach you)*
23. Do you understand that there is no appeal allowed from the submission of an online mitigation request?*

    1. Yes, I understand I am not allowed to appeal the Court's order.
25. My statement to the Judge about my ticket:*
27. If you are not able to pay a fine within 60 days, please explain how much you can pay a month on a payment plan.
29. Documents Sent to Court Email*

    1. I understand that if I want the Judge to consider any additional documents, photos, etc. I must email those to court@bainbridgewa.gov the same day this submission is sent my name and ticket number.
31. Certification*

    1. I certify or declare under penalty of perjury under the laws of the State of Washington that the attached statement is true and correct. I promise that I will pay the monetary penalty.
Leave This Blank:


32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit Submit and Print

* indicates a required field