a Uniform Traffic Citation (“UTC”) was issued by a law enforcement officer to the driver of the motor vehicle for the violation of Florida Statutes sections 316.074(1) and 316.075(1)(c)1.
The affidavit must be sworn before a notary public or other person authorized to administer oaths. If you assert that the vehicle was in the care, custody, or control of another person, you must provide the name, address, date of birth, and, if known, the driver’s license number of the person who leased, rented, or otherwise had care, custody, or control of the vehicle at the time of the violation. If the vehicle was stolen, then the affidavit must include a copy of a police report showing the vehicle to have been stolen. If you assert that a UTC was issued by a law enforcement officer for the violation of Florida Statutes sections 316.074(1) and 316.075(1)(c)1 stated in this Notice, then you must include the serial number of the UTC. For faster processing, you may, but are not required to, include a copy of the UTC. If your affidavit complies with the requirements of Florida Statute § 316.0083, then no further action will be taken against you.
The submission of a false affidavit is a misdemeanor of the second degree, punishable under Florida Statute section 775.082 or section 775.083 by a term of imprisonment not to exceed sixty (60) days and/or a fine not to exceed $500.00.
If submitting an affidavit, it must be postmarked on or before the due date specified on the front page of this Notice in order to be appropriately processed.
The affidavit should be mailed to:
Town of Medley
Intersection Safety Program
PO Box 22091
Tempe, AZ 85285-2091