Diversion Program Registration Step 1 of 6 16% Thank you for participating in the Steuben County, NY Diversion Program. This program is intended to help you resolve your traffic violation quickly and easily, with no points on your license and with little or no impact on your automobile insurance policy premiums. This form is divided into three sections: Determine whether or not you are eligible to participate in the program. Provide us with your personal information. Make your payment using your credit card or debit card. You will need your driver's license, a copy of your Standard Driver's Record (Abstract), a picture or scan of your ticket(s) saved in JPG, PDF, PNG, or GIF format, a letter from your insurance company providing coverage for all damages in the event of a motor vehicle accident, and a method of payment (credit/debit card), in order to complete this process. If you have the proper information available, this process should take no more than fifteen (15) minutes to complete. If you have questions, please email us at help@DiversionConnect.com or call us at 866.250.6050. Section 1: Eligibility Most traffic violations will qualify for diversion, but the Steuben County District Attorney's office will be reviewing your application to determine eligibility and reserves the right to deny your participation in the program. You can use this site to submit your registration form, pay your fee, find an accredited defensive driving course, upload documents, and get answers to your questions. Your application will then be reviewed by the Steuben County District Attorney's Office. If your application is rejected, you will receive a refund of your application fee. If you are accepted into the Traffic Diversion Program your application fee is non-refundable. Some more serious Vehicle and Traffic violations may not be eligible for participation in the Traffic Diversion Program. You are not eligible for the Traffic Diversion program if you meet any of the following criteria (this is not an exhaustive list of reasons for exclusion): Your citation must not be for a speed 25+ MPH over the posted speed limit. It also must not have occurred in a work or a school zone. Please apply instead for reduction. Your citation must not be for a violation involving an emergency vehicle. You must not have been involved in a motor vehicle accident resulting in physical injury or death. The motorist must not have availed themselves of this or a similar program within 18 months of the date of the issuance of the Uniform Traffic Ticket. The motorist must not have more than eight (8) Uniform Traffic Tickets from any single traffic stop. The motorist must not have been disrespectful to the officer during the traffic stop. If your ticket is for violation 511-1 - Aggravated Unlicensed Operation 3rd (Misd) please be aware that despite your enrollment status in the program, the court may still require you to appear for your scheduled court date or hire an attorney to appear on your behalf. Important: If there is a property damage motor vehicle accident, the motorist must obtain an insurance indemnification letter from your insurance carrier indicating that the insurance carrier is on notice of the accident and that any claim has been paid. The letter alone will not qualify you for the program an individual assessment will be made and admission is not a guarantee. The District Attorney's Office will be reviewing your application to determine eligibility, based upon your driving record and any other aggravating circumstances. The District Attorney's Office will make the final determination as to your eligibility. *PLEASE NOTE* If you received a ticket for 1144-(A) or 1144-A(A) it is ineligible for both the Traffic Diversion Program and the Reduction Program. Please contact the appropriate court to proceed with the resolution of your citation. By selecting "Yes" below ... You understand that completion of this form and submission of payment does not guarantee your acceptance into the Traffic Diversion Program. You understand that your payment is non-refundable unless you are not accepted into the Steuben County Traffic Diversion Program. Once accepted, your payment is non-refundable. You understand that regardless of your completion of this form, you are required to appear in court on the date shown on your ticket(s) unless you are specifically told not to appear. If you wish to proceed with the application, please check the "Yes" option below and hit the "Next" button. If you do not wish to continue, simply click here. You will be returned to the Steuben County Diversion Program Website Home Page.I wish to continue* Yes **Please make sure to input all information completely and carefully. If your application is missing any component(s) you will be required to fill it out again.** Section 2: Your Contact Information Please complete all of the following fields. Your email address is important as it will be used to confirm your application in this program. Failure to provide the correct email address may result in delays in the processing of your application and disqualification from the Diversion Program.Name* First Last Date of Birth* MM slash DD slash YYYY Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AnguillaAntarcticaAntigua and BarbudaArab Republic of EgyptArgentine RepublicArubaBailiwick of GuernseyBailiwick of JerseyBaker IslandBarbadosBassas da IndiaBelizeBermudaBolivarian Republic of VenezuelaBosnia and HerzegovinaBouvet IslandBritish Indian Ocean TerritoryBritish Virgin IslandsBurkina FasoCanadaCayman IslandsCentral African RepublicClipperton IslandCo-operative Republic of GuyanaCommonwealth of AustraliaCommonwealth of DominicaCommonwealth of Puerto RicoCommonwealth of The BahamasCommonwealth of the Northern Mariana IslandsCook IslandsCoral Sea Islands TerritoryCzech RepublicDemocratic People’s Republic of KoreaDemocratic Republic of East TimorDemocratic Republic of Sao Tome and PrincipeDemocratic Republic of the CongoDemocratic Socialist Republic of Sri LankaDepartment of GuadeloupeDepartment of GuianaDepartment of MartiniqueDepartment of ReunionDominican RepublicEuropa IslandFalkland Islands (Islas Malvinas)Faroe IslandsFederal Democratic Republic of EthiopiaFederal Islamic Republic of the ComorosFederal Republic of GermanyFederal Republic of NigeriaFederated States of MicronesiaFederation of Saint Kitts and NevisFederative Republic of BrazilFrench RepublicGabonese RepublicGaza StripGeorgiaGibraltarGlorioso IslandsGrand Duchy of LuxembourgGreat Socialist People’s Libyan Arab JamahiriyaGreenlandGrenadaHashemite Kingdom of JordanHellenic RepublicHong Kong Special Administrative RegionHowland IslandIndependent Stat of Papua New GuineaIndependent State of SamoaInternational bodies of waterInternational undersea featuresIrelandIslamic Republic of AfghanistanIslamic Republic of IranIslamic Republic of PakistanIsle of ManItalian RepublicJamaicaJan MayenJapanJarvis IslandJohnston AtollJuan de Nova IslandKingdom of BahrainKingdom of BelgiumKingdom of BhutanKingdom of CambodiaKingdom of DenmarkKingdom of LesothoKingdom of MoroccoKingdom of NepalKingdom of NorwayKingdom of Saudi ArabiaKingdom of SpainKingdom of SwazilandKingdom of SwedenKingdom of ThailandKingdom of TongaKingdom of the NetherlandsKingman ReefKyrgyz RepublicLao People’s Democratic RepublicLebanese RepublicMacau Special Administrative RegionMalaysiaMidway IslandsMongoliaMontserratMyanmar (Burma)Navassa IslandNegara Brunei DarussalamNetherlands AntillesNew ZealandNiueOriental Republic of UruguayPalmyra AtollParacel IslandsPeople’s Democratic Republic of AlgeriaPeople’s Republic of BangladeshPeople’s Republic of ChinaPitcairn, Henderson, Ducie, and Oeno IslandsPortuguese RepublicPrincipality of AndorraPrincipality of LiechtensteinPrincipality of MonacoRepublic of AlbaniaRepublic of ArmeniaRepublic of AustriaRepublic of AzerbaijanRepublic of BelarusRepublic of BeninRepublic of BoliviaRepublic of BotswanaRepublic of BulgariaRepublic of BurundiRepublic of CameroonRepublic of Cape VerdeRepublic of ChadRepublic of ChileRepublic of ColombiaRepublic of Costa RicaRepublic of Cote d’IvoireRepublic of CroatiaRepublic of CubaRepublic of CyprusRepublic of DjiboutiRepublic of EcuadorRepublic of El SalvadorRepublic of Equatorial GuineaRepublic of EstoniaRepublic of FinlandRepublic of GhanaRepublic of GuatemalaRepublic of GuineaRepublic of Guinea-BissauRepublic of HaitiRepublic of HondurasRepublic of HungaryRepublic of IcelandRepublic of IndiaRepublic of IndonesiaRepublic of IraqRepublic of KazakhstanRepublic of KenyaRepublic of KiribatiRepublic of KoreaRepublic of LatviaRepublic of LiberiaRepublic of LithuaniaRepublic of MadagascarRepublic of MalawiRepublic of MaldivesRepublic of MaliRepublic of MaltaRepublic of MauritiusRepublic of MoldovaRepublic of MozambiqueRepublic of NamibiaRepublic of NauruRepublic of NicaraguaRepublic of NigerRepublic of PalauRepublic of PanamaRepublic of ParaguayRepublic of PeruRepublic of PolandRepublic of San MarinoRepublic of SenegalRepublic of SeychellesRepublic of Sierra LeoneRepublic of SingaporeRepublic of SloveniaRepublic of South AfricaRepublic of SurinameRepublic of TajikistanRepublic of Trinidad and TobagoRepublic of TunisiaRepublic of TurkeyRepublic of UgandaRepublic of UzbekistanRepublic of VanuatuRepublic of YemenRepublic of ZambiaRepublic of ZimbabweRepublic of the CongoRepublic of the Fiji IslandsRepublic of the GambiaRepublic of the Marshall IslandsRepublic of the PhilippinesRepublic of the SudanRepublic on AngolaRomaniaRussian FederationRwandese RepublicSaint HelenaSaint LuciaSaint Vincent and the GrenadinesSerbia and MontenegroSlovak RepublicSocialist Republic of VietnamSolomon IslandsSomaliaSouth Georgia and the South Sandwich IslandsSpratly IslandsState of EritreaState of IsraelState of KuwaitState of QatarSultanate of OmanSvalbardSwiss ConfederationSyrian Arab RepublicTaiwanTerritorial Collectivity of MayotteTerritorial Collectivity of Saint Pierre and MiquelonTerritory of Ashmore and Cartier IslandsTerritory of Christmas IslandTerritory of Cocos (Keeling) IslandsTerritory of French PolynesiaTerritory of GuamTerritory of Heard Island and McDonald IslandsTerritory of New Caledonia and DependenciesTerritory of Norfolk IslandTerritory of the French Southern and Antarctic LandsTerritory of the Wallis and Futuna IslandsThe Former Yugoslav Republic of MacedoniaThe Holy See (State of the Vatican City)Togolese RepublicTokelauTromelin IslandTurkmenistanTurks and Caicos IslandsTuvaluUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited Mexican StatesUnited Republic of TanzaniaUnited States Virgin IslandsUnited States of AmericaWake IslandWest BankWestern Sahara Cell Phone Number*Be sure to include your area code.Preferred Contact Number*This may be the same as your cell phone number. Be sure to include your area code.My preferred contact number is my ...* Cell Phone Home Phone Work Phone Email*(please enter your email address twice) Enter Email Confirm Email Please check this box IF AND ONLY IF you have an attorney representing you FOR THIS TICKET(S)If you are not currently being represented by an attorney, please proceed to the next page. Yes an attorney is representing me for this ticket(s) Attorney Name*This field is only required if the registrant is being represented by an attorney. First Last Attorney Phone*This field is only required if the registrant is being represented by an attorney.Attorney Email*This field is only required if the registrant is being represented by an attorney. Enter Email Confirm Email Attorney Address*These fields are only required if the registrant is being represented by an attorney. Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AnguillaAntarcticaAntigua and BarbudaArab Republic of EgyptArgentine RepublicArubaBailiwick of GuernseyBailiwick of JerseyBaker IslandBarbadosBassas da IndiaBelizeBermudaBolivarian Republic of VenezuelaBosnia and HerzegovinaBouvet IslandBritish Indian Ocean TerritoryBritish Virgin IslandsBurkina FasoCanadaCayman IslandsCentral African RepublicClipperton IslandCo-operative Republic of GuyanaCommonwealth of AustraliaCommonwealth of DominicaCommonwealth of Puerto RicoCommonwealth of The BahamasCommonwealth of the Northern Mariana IslandsCook IslandsCoral Sea Islands TerritoryCzech RepublicDemocratic People’s Republic of KoreaDemocratic Republic of East TimorDemocratic Republic of Sao Tome and PrincipeDemocratic Republic of the CongoDemocratic Socialist Republic of Sri LankaDepartment of GuadeloupeDepartment of GuianaDepartment of MartiniqueDepartment of ReunionDominican RepublicEuropa IslandFalkland Islands (Islas Malvinas)Faroe IslandsFederal Democratic Republic of EthiopiaFederal Islamic Republic of the ComorosFederal Republic of GermanyFederal Republic of NigeriaFederated States of MicronesiaFederation of Saint Kitts and NevisFederative Republic of BrazilFrench RepublicGabonese RepublicGaza StripGeorgiaGibraltarGlorioso IslandsGrand Duchy of LuxembourgGreat Socialist People’s Libyan Arab JamahiriyaGreenlandGrenadaHashemite Kingdom of JordanHellenic RepublicHong Kong Special Administrative RegionHowland IslandIndependent Stat of Papua New GuineaIndependent State of SamoaInternational bodies of waterInternational undersea featuresIrelandIslamic Republic of AfghanistanIslamic Republic of IranIslamic Republic of PakistanIsle of ManItalian RepublicJamaicaJan MayenJapanJarvis IslandJohnston AtollJuan de Nova IslandKingdom of BahrainKingdom of BelgiumKingdom of BhutanKingdom of CambodiaKingdom of DenmarkKingdom of LesothoKingdom of MoroccoKingdom of NepalKingdom of NorwayKingdom of Saudi ArabiaKingdom of SpainKingdom of SwazilandKingdom of SwedenKingdom of ThailandKingdom of TongaKingdom of the NetherlandsKingman ReefKyrgyz RepublicLao People’s Democratic RepublicLebanese RepublicMacau Special Administrative RegionMalaysiaMidway IslandsMongoliaMontserratMyanmar (Burma)Navassa IslandNegara Brunei DarussalamNetherlands AntillesNew ZealandNiueOriental Republic of UruguayPalmyra AtollParacel IslandsPeople’s Democratic Republic of AlgeriaPeople’s Republic of BangladeshPeople’s Republic of ChinaPitcairn, Henderson, Ducie, and Oeno IslandsPortuguese RepublicPrincipality of AndorraPrincipality of LiechtensteinPrincipality of MonacoRepublic of AlbaniaRepublic of ArmeniaRepublic of AustriaRepublic of AzerbaijanRepublic of BelarusRepublic of BeninRepublic of BoliviaRepublic of BotswanaRepublic of BulgariaRepublic of BurundiRepublic of CameroonRepublic of Cape VerdeRepublic of ChadRepublic of ChileRepublic of ColombiaRepublic of Costa RicaRepublic of Cote d’IvoireRepublic of CroatiaRepublic of CubaRepublic of CyprusRepublic of DjiboutiRepublic of EcuadorRepublic of El SalvadorRepublic of Equatorial GuineaRepublic of EstoniaRepublic of FinlandRepublic of GhanaRepublic of GuatemalaRepublic of GuineaRepublic of Guinea-BissauRepublic of HaitiRepublic of HondurasRepublic of HungaryRepublic of IcelandRepublic of IndiaRepublic of IndonesiaRepublic of IraqRepublic of KazakhstanRepublic of KenyaRepublic of KiribatiRepublic of KoreaRepublic of LatviaRepublic of LiberiaRepublic of LithuaniaRepublic of MadagascarRepublic of MalawiRepublic of MaldivesRepublic of MaliRepublic of MaltaRepublic of MauritiusRepublic of MoldovaRepublic of MozambiqueRepublic of NamibiaRepublic of NauruRepublic of NicaraguaRepublic of NigerRepublic of PalauRepublic of PanamaRepublic of ParaguayRepublic of PeruRepublic of PolandRepublic of San MarinoRepublic of SenegalRepublic of SeychellesRepublic of Sierra LeoneRepublic of SingaporeRepublic of SloveniaRepublic of South AfricaRepublic of SurinameRepublic of TajikistanRepublic of Trinidad and TobagoRepublic of TunisiaRepublic of TurkeyRepublic of UgandaRepublic of UzbekistanRepublic of VanuatuRepublic of YemenRepublic of ZambiaRepublic of ZimbabweRepublic of the CongoRepublic of the Fiji IslandsRepublic of the GambiaRepublic of the Marshall IslandsRepublic of the PhilippinesRepublic of the SudanRepublic on AngolaRomaniaRussian FederationRwandese RepublicSaint HelenaSaint LuciaSaint Vincent and the GrenadinesSerbia and MontenegroSlovak RepublicSocialist Republic of VietnamSolomon IslandsSomaliaSouth Georgia and the South Sandwich IslandsSpratly IslandsState of EritreaState of IsraelState of KuwaitState of QatarSultanate of OmanSvalbardSwiss ConfederationSyrian Arab RepublicTaiwanTerritorial Collectivity of MayotteTerritorial Collectivity of Saint Pierre and MiquelonTerritory of Ashmore and Cartier IslandsTerritory of Christmas IslandTerritory of Cocos (Keeling) IslandsTerritory of French PolynesiaTerritory of GuamTerritory of Heard Island and McDonald IslandsTerritory of New Caledonia and DependenciesTerritory of Norfolk IslandTerritory of the French Southern and Antarctic LandsTerritory of the Wallis and Futuna IslandsThe Former Yugoslav Republic of MacedoniaThe Holy See (State of the Vatican City)Togolese RepublicTokelauTromelin IslandTurkmenistanTurks and Caicos IslandsTuvaluUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited Mexican StatesUnited Republic of TanzaniaUnited States Virgin IslandsUnited States of AmericaWake IslandWest BankWestern Sahara Country All of the information requested below can be found on your New York State Driver's License. Out of state drivers will have similar information on their licenses.Driver's License Issuing State/Province*Use abbreviations only -- e.g., NY, PA, OH, ON. If you do not have a license, please enter the state or province where you currently live.DMV ID Number from your Driver's License*No spaces or dashes -- numbers and/or letter only. Examples shown above circled in red. If you do not have a driver's license, please enter "No License."Driver's License Expiration Date*Date (examples shown above, circled in green). If you do not have a license, please enter today's date. MM slash DD slash YYYY Automobile Insurance Information All of the information requested below can be found on the New York State Insurance Identification Card that you keep in your vehicle. Other states have similar documentation requirements.This field is hidden when viewing the formAutomobile Insurance Companye.g., Allstate, GEICO, State FarmThis field is hidden when viewing the formInsurance Policy NumberThis field is hidden when viewing the formInsurance Policy Expiration Date MM slash DD slash YYYY I will not drive without insurance.* I Agree Have you participated in a Traffic Diversion Program or received a reduction on a traffic ticket in the past 2 years?* Yes No You are only able to participate in a Traffic Diversion Program once in an 18 month period. Past participants (in the last 18 months) or multiple applications will not be eligible. Section 3: Violation InformationPlease complete all of the following fields. It is critical that you enter your ticket number(s) AND violation number(s) correctly into the appropriate field(s) below and upload pictures or scans of the requested documents. Failure to provide all required information will result in delays in the processing of your application and possible disqualification from the Diversion Program. Be sure to include the ticket numbers AND violation numbers from all outstanding citations. Violations not listed will not be eligible for inclusion in the Diversion Program and you will be required to appear in court.When did your traffic stop occur?*If you're not sure, refer to the citation you received. MM slash DD slash YYYY Using the above diagram and your traffic citation(s) as a reference, please answer the following questions ...Citation Number*Enter the citation number displayed in the upper left corner of the ticket. The citation (or ticket) number is shown in the above image circled in ORANGE. DO NOT ENTER THE TICKET NUMBER FROM THE SAMPLE TICKET PICTURED ABOVE! YOU MUST USE THE TICKET NUMBER(S) THAT APPEAR ON THE PAPER VERSION(S) YOU RECEIVED AT YOUR TRAFFIC STOP! If you received more than one (1) citation during this traffic stop, select any one of your citation numbers for this field. Please re-enter the above Citation Number (for confirmation)*If (and only if) you received more than one citation during the traffic stop, enter the remaining ticket numbers below. Enter the citation number for each ticket you received. DO NOT INCLUDE THE TICKET YOU ENTERED IN THE PREVIOUS FIELD ABOVE.Enter one citation number per line. The citation (or ticket) number is shown in the above sample ticket image circled in ORANGE.Violations List Instructions Enter the Violation Section Number and the Description of Violation from your ticket in the Violations List field below. This number is shown in the above sample ticket image circled in BLUE. If you received more than one citation during the traffic stop, you must enter the violation section numbers for ALL tickets you are submitting today.***Please note that any speed violation over 90 MPH is NOT eligible for the Traffic Diversion Program. You should instead apply for a reduction by clicking here. Speed violations that occurred in a construction or school zone are NOT eligible for the Traffic Diversion Program. You should instead apply for a reduction at the link above. If you do apply for Diversion and it is found that your violation occurred within a construction or school zone, you may be denied a plea offer. If you received a violation for 1144-(A) or 1144-A(A), these violations are not eligible for the Traffic Diversion Program nor are they eligible for a reduction. Please contact the court listed on your ticket for information on how to resolve these types of violations. PLEASE NOTE: If you decide to participate in the Traffic Diversion Program for a 511-1 - Aggravated Unlicensed Operation 3rd (Misd) ticket please be aware that despite your enrollment status in the program, the court may still require you to appear for your scheduled court date or hire an attorney to appear on your behalf.* I have read and agree to the above statement and wish to continue registering for the Traffic Diversion Program for a 511-1 - Aggravated Unlicensed Operation 3rd (Misd) ticket. Violation Fees C/T/V Name (location where violation occurred)*Please select the Court Location as indicated on your traffic citation (see the GREEN circle on the sample ticket above). Town of ADDISON Village of ADDISON Village of ALMOND Village of ARKPORT Town of AVOCA Village of AVOCA Town of BATH Village of BATH Town of BRADFORD Town of CAMERON Town of CAMPBELL Town of CANISTEO Village of CANISTEO Town of CATON Town of COHOCTON Village of COHOCTON City of CORNING Town of CORNING Town of DANSVILLE Town of ERWIN Town of FREMONT Town of GREENWOOD Village of HAMMONDSPORT Town of HARTSVILLE Town of HORNBY City of HORNELL Town of HORNELLSVILLE Town of HOWARD Town of JASPER Town of LINDLEY Village of NORTH HORNELL Village of PAINTED POST Town of PRATTSBURG Town of PULTENEY Town of RATHBONE Village of RIVERSIDE Village of SAVONA Village of SOUTH CORNING Town of THURSTON Town of TROUPSBURG Town of TUSCARORA Town of URBANA Town of WAYLAND Village of WAYLAND Town of WAYNE Town of WEST UNION Town of WHEELER Town of WOODHULL Court Location*Please select the Court Location as indicated on your traffic citation (see the RED circle on the sample ticket above). Town of ADDISON Town of AVOCA Town of BATH Village of BATH Town of BRADFORD Town of CAMERON Town of CAMPBELL Town of CANISTEO Village of CANISTEO Town of CATON Town of COHOCTON Village of COHOCTON City of CORNING Town of CORNING Town of DANSVILLE Town of ERWIN Town of FREMONT Town of GREENWOOD Town of HARTSVILLE Town of HORNBY City of HORNELL Town of HORNELLSVILLE Town of HOWARD Town of JASPER Town of LINDLEY Town of PRATTSBURG Town of PULTENEY Town of RATHBONE Village of SAVONA Town of THURSTON Town of TROUPSBURG Town of TUSCARORA Town of URBANA Town of WAYLAND Village of WAYLAND Town of WAYNE Town of WEST UNION Town of WHEELER Town of WOODHULL State (or Province) of Registration of the vehicle involved in the infraction*Use abbreviations only -- e.g., NY, PA, OH, ONLicense Plate number of the vehicle you were driving when the infraction(s) took place*Attach a photograph or scan of your citation(s).*If you received more than one citation, upload a copy of each ticket separately. This will ensure faster processing of your Diversion Program registration. You can upload multiple files. IMPORTANT: it may take a moment for the file(s) to upload. Please wait until you see the name(s) of each of the file(s) that you uploaded listed below BEFORE you move to the next question. You can delete a file by clicking the button next to the file name. If you need help with uploading your citations, please click here. This will open a new window and you will not lose your place on this form. Drop files here or Select files Accepted file types: jpg, gif, png, pdf, jpeg, Max. file size: 128 MB. Driver's Abstract Upload*Please upload a current copy of your driving record (abstract) from your local NYS Department of Motor Vehicle. These may also be purchased online at https://dmv.ny.gov/dmv-records/get-my-own-driving-record-abstract. Out-of-state and Canadian drivers must provide their driving record from their home state or country. Our office will accept non-certified abstracts, with a minimum of 18 months driving history. Drop files here or Select files Accepted file types: jpg, gif, png, pdf, jpeg, Max. file size: 128 MB. Was there an accident?* Yes No Upload an indemnification letter from your insurance carrier.*Our office will need a letter from your insurance company stating all property/personal injury damages have been paid in full. Drop files here or Select files Accepted file types: jpg, gif, pdf, png, jpeg, Max. file size: 128 MB. Today's Date* MM slash DD slash YYYY By signing this form, you acknowledge that you have read and understood the following Violator's Rights: You have the right to have your violation addressed through the court system. You have the right to have your violation reviewed by a judge. You also have the right to have an attorney represent you and the court may determine that you are eligible for a free attorney if you cannot afford one. If you choose to go to court, you or your attorney have the right to discovery of records involved as well. If you register for the Diversion Program and are approved, you will not need to attend court and your penalties will be far less than if found guilty. This is possible because this program is not about punishment, but rather public safety and respect. This program is designed to make our community safer for everyone. In order for the program to work, however, you must, if accepted, waive all claims to a speedy trial and discovery. When accepted into the program, you will receive a notification and the District Attorney’s Office will advise the court to adjourn your case while you complete the program. In the event you fail to complete the program within sixty (60) days of the date of acceptance into the program, you will be required to contact the court and to appear in court on a date provided to you by the court or your driving privileges may be suspended without further notice, as well as other additional sanctions. Upon successful completion of the program (within the allotted time), you and the court will receive notification that the Steuben County District Attorney’s Office is withdrawing the violations pending against you. The Registration Form has the following language which you must sign: I hereby understand that by registering as a participant in the Steuben County Traffic Diversion Program, I am waiving my right to a speedy trial, pursuant to Article 30 of the Criminal Procedure Law and that I will not receive any further discovery to which I am entitled pursuant to Article 245 of the Criminal Procedure Law, I am hereby requesting an adjournment of the case for at least sixty (60) days so that I have adequate time to complete the Traffic Diversion Program offered to me. I agree that failure to respond to the information sought or the giving of false or incorrect information on this registration form is grounds to deny me Diversion or remove me from the program. I acknowledge that I understand that it is a crime punishable as a Class A Misdemeanor under the laws of New York for a person in and by a written instrument to knowingly make a false statement or to make a statement, which such person does not believe is true and pledge that I have not done so on the Registration Form. Warning: If you have not received a notice by email or any other form of communication from the District Attorney’s office that your Traffic Diversion registration was approved, you must appear at the date and time indicated. Failure to do so will result in the suspension of your license and other possible sanctions. You will lose the registration fee you have paid. If you have any questions, please contact our helpdesk at 866.250.6050. AFFIRMED UNDER PENALTY OF PERJURY The starting fees for the Steuben County Traffic Diversion Program range between $150 and $375, depending upon the infraction cited. Additional citations received at the same traffic stop will add an additional $75 per violation. The total amount you owe has been calculated for you and is displayed at the bottom of this page. After you complete the credit card/debit card data entry, a nominal service fee will be added on as well. By signing your name below (with a mouse on a computer, or with your finger on a touchscreen or mobile device), you acknowledge that you have read and understand your rights as listed above.Registrant's Signature*Please sign your name with a mouse on a computer, or with your finger on a touchscreen or mobile device.Credit CardDO NOT ENTER SPACES OR DASHES BETWEEN NUMBERS. DiscoverMasterCardVisaSupported Credit Cards: Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20252026202720282029203020312032203320342035203620372038203920402041204220432044 Expiration Date Security Code Cardholder Name Service Fee Price: Total $0.00 Violations List*2 persons on seat for 1 | 1251 - (a)3' side racks - truck carrying people | 1222 - 1bAbandoned vehicle | 1224 - 7aAggravated unlicensed operation 3E | 511 - 1Alteration of license conviction stub | 515Attached handbills to windshield | 375 - 1bAvoided intersection/traffic control device | 1225Carrying object/2 hands not on handlebars | 1251 - (c)Clinging to other vehicles | 1253Crossing fire hose | 1218Dazzling lights | 375 - 2(b)Disobeyed stop sign | 1172 - (a)Drive on shoulder | 1131Driver on left failed to yield in intersection | 1140 - (b)Driver/ passenger used alcholic beverage in MV | 1227 - 1Drivers View Obstructed | 375 - 30Driving on sidewalk | 1225-aDrove across hazardous markings | 1128 - (d)Drove across mall/median | 1130 - 1Drove left of pavement markings | 1126 - (a)Drove through safety zone | 1221Dumping snow in handicapped area | 1203-eEntered intersection when room unavailable (gridlock) | 1175Fail to change address on license | 509 - 8Fail to change address on registration | 401 - 3aFail to exercise care to avoid collision with bicyclist/pedestrian/dom. animal | 1146Fail to exhibit license to magistrate | 509 - 7Fail to obey order of police/flag person | 1102Fail to stop at red signal before turning rt/fail to yield to ped/traffic (1-way) | 1111 - (d)2bFail to stop at red signal before turning rt/fail to yield to ped/traffic (2-way) | 1111 - (d)2aFail to stop - stop sign/failed to yield | 1142 - (a)Fail to yield approaching intersection | 1140 - (a)Fail to yield at traffic circle | 1145Fail to yield - entering roadway | 1143Fail to yield - left turn | 1141Fail to yield to pedestrian in crosswalk | 1151 - (a)Fail to yield with green arrow | 1111 - (a)2Fail to yield with green light | 1111 - (a)1Fail to yield - yield sign | 1142 - (b)Failed to designate area for handicapped | 1203-c - 1Failed to dim - meeting/overtaking | 375 - 3Failed to give way when being passed | 1122 - (b)Failed to keep right | 1120 - (a)Failed to keep right (slow moving vehicle) | 1120 - (b)Failed to leave sufficient space | 1129 - (b)Failed to leave sufficient space (motorcade, except funerals) | 1129 - (c)Failed to obey traffic control device/police sign | 1110 - (a)Failed to properly identify area for handicapped | 1203-c - 2Failed to signal for turn | 1163 - (b)Failed to signal when stopping | 1163 - (c)Failed to stop - emerging from alley/driveway/private road/building | 1173Failed to stop for yield sign when required | 1172 - (b)Failed to turn as required | 1160 - (d)Failed to use designated lane | 1128 - (c)Failed to use emergency flashers | 1163 - (e)Failed to yield one-half roadway | 1121Failure to stop at flashing red signal | 1113 - (a)Failure to surrender registration, plates, license after revocation | 318 - 7Falsifying temporary indicia of registration | 403-aFld/Display Num. Plates | 2264-1Following fire apparatus too closely | 1217Following too closely | 1129 - (a)Front or rear view obstructed | 375 - 30Front seat under 16 no seat belt | 1229-c - 2Front seat under 7 not in child restraint seat | 1229-c - 2Glass broken/fractured/discolored so visibility is distorted | 375 - 22Handlebars over operator's shoulders | 381 - 5Holding more than 1 NYS license | 509 - 5Impeding traffic - driving too slowly | 1181 - (a)Improper insurance card | 319 - 2Improper left turn off roadway | 1166 - (b)Improper left turn (one-way) | 1160 - (c)Improper left turn (one-way) off roadway | 1166 - (c)Improper left turn (two-way) | 1160 - (b)Improper/No signal | 1163 - (d)Improper plates | 402 - 4Improper plates-Motorcycle | 411 - 3Improper right turn | 1160 - (a)Improper right turn off roadway | 1166 - (a)Improper towing | 375 - 29Improper/unsafe turn | 1163 - (a)Improperly Equipped W/ TV Receiver | 375-24Issue or use fake/counterfeit inspection certificate | 306 (e)Leaving engine on/key in unattended MV | 1210 - (a)Left pavement to pass on right | 1123 - (b)Left scene accident with property damage | 600 - 1aInadequate steering/brakes/Loud or unnecessary horn | 375 - 1aMC/MV deprives MC use of full lane | 1252 - (a)MC operating between autos | 1252 - (c)MC passing in same lane | 1252 - (b)Misuse/unlawful disposal of traffic summons | 207 - 5More than 1 State plate/no contrast of color | 402 - 2More than 2 abreast in same lane | 1252 - (d)Moved from lane unsafely | 1128 - (a)Moved stopped vehicle unsafely | 1162No adjustable interior mirror | 375 - 10c rNo directionals - certain vehicles | 1164 - (b)No distinctive no plate-Motorcycle | 411 - 1No flashing light on front & rear of bus | 375 - 20(a)No front or rear bumper | 375 - 48bNo/improper backup lights | 375 - 34No/inadequate brake lights | 375 - 40(b)No/inadequate directionals | 375 - 18No/inadequate goggles/face shield | 381 - 7No/inadequate headlights (MV) when dark/wipers in use | 375 - 2(a)1No/inadequate helmet | 381 - 6No/inadequate light – bicycle | 1236 - A(1)No/inadequate light – bicycle | 1236 - A(2)No/inadequate muffler MV | 375 - 31No/inadequate muffler or MC equipped w/straight pipes | 381 - 11No/inadequate plate light | 375 - 2(a)4No/inadequate tail lights (2-lamp) | 375 - 2(a)3No left side view mirror | 375 - 10-aNo light/red flag on load | 375 - 27No mirror on MV | 375 - 10aNo/More than one sticker | 0403-01No notice of disability | 509 - 9No Overweight/Size Permit | 385-15No seat belt | 1229-c - 3No seats - truck carrying people | 1222 - 1aNo Stopping/Standing/Parking on Highway | 1201-ANo tailgate - truck carrying people | 1222 - 1cNontransparent windshield | 375 - 12-aObstructed vision/4 persons in front seat | 1213 - (a)Opened door unsafely | 1214Operate/permit operation w/o financial security | 319 - 1Operating MV/MC/BIC with more than one earphone | 37524AOperating out of appropriate class | 509 - 2Operating out of restriction | 509 - 3Operating w/o license | 509 - 1Operating with more than 2 passengers under 21 (DJ/MJ License) | 501-B(2b)Operation w/suspended registration | 512Operator side windows less than 70% light transmittance | 375 - 12-a(b)(1)Overlength Vehicle-Combination | 385-4AOwner of vehicle used wrong plate | 402 - 6Parked in handicapped area (off street) | 1203-c - 4Parked within 1000' of fire scene | 1217Passed circular red signal | 1111 - (d)1Passed red arrow | 1111 - (d)3Passed vehicle on right | 1122 - (a)Passenger interfered with driver | 1251 - (d)Passenger obstructed view/interfered with driver | 1213 - (b)Pedestrian crossed against red signal | 1111 - (d)4Pedestrian crossed against yellow signal | 1111 - (b)3Permit improper use of license/use or possess forged license | 509 - 6Permitted improper use of plates | 402 - 5Permitted use of improper plates-Motorcycle | 411 - 4Permitting unlicensed operation | 509 - 4Plate not issued by commissioner-Motorcycle | 411 - 2Plates/obstructed/dirty/insecure/none/one/no distinct # | 402Radio playing in excess of 70 decibels | 375 - 47aRear seat under 16 no seat belt | 1229-c - 1Rear seat under 7 not in child restraint seat | 1229-c - 1Refusal of screening test | 1194 - 2(b)Registration tag not on windshield | 402Removed both hands from wheel | 1226Right on red/school bus transporting pupils | 1111 - (d)5School bus sign not lighted | 375 - 20(c)Sell, install, use "straight pipes" MC muffler | 375 - 31-aSitting improperly/astride seat | 1251 - (b)Speed not reasonable/prudent | 1180 - (a)Speed in Zone - 1 to 20 MPH over the posted limit | 1180 - (d)Speed in Zone - 21 to 24 MPH over the posted limit | 1180 - (d)Speeding over State limit - 25 to 29 MPH over the limit (PRIOR APPROVAL REQUIRED) | 1180 - (b)Speeding over State limit - 1 to 20 MPH over the limit | 1180 - (b)Speeding over State limit - 21 to 24 MPH over the limit | 1180 - (b)Stop/stand/parked in handicapped area (street) | 1203-b - 2Switched trailer plate | 401 - 1b(2)Switched trailer plate (While operating a Commercial Vehicle with trailer) | 401 - 1b(1)Threw/Deposited Glass/Etc On Highway | 1219-1ATruck carrying 6 people w/o person 18 yrs | 1222 - 2U-turn at grade/curve | 1161Unapproved headlights | 375 - 4Unauthorized amber light | 375 - 41-3Unauthorized blue light/improper use | 375 - 41-4Unauthorized. entry/exit controlled access highway | 1130 - 2Unauthorized gong/siren (not anti-theft device) | 375 - 26Unauthorized green light/improper use | 375 - 41-5Unauthorized light/revolving, flashing, etc. | 375 - 41-1Unauthorized light/s | 375 - 2(c)Unauthorized red and white light | 375 - 41-2Unauthorized speed contest (drag race) | 1182 - 1Improper wipers/Unauthorized stickers | 375 - 1bUninspected MV | 306 (b)Unnecessary smoke/offensive vapors | 375 - 28Unregistered motor vehicle | 401 - 1aUnregistered Motorcycle | 410 - 1Unregistered trailer | 402 - 3Unsafe backing | 1211 - (a)Use mobile telephone while driving | 1225-c - 2aUse portable electronic device while driving | 1225-d - 1While passing on left, interfered with safe operation of oncoming veh. | 1124Windshield less than 70% light transmittance | 375 - 12-a(b)(1)Wrong way on one-way street | 1127 - (a)PhoneThis field is for validation purposes and should be left unchanged. 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