Ride Safe Maricopa - Diversion Course Completion Form

When completing the form, carefully enter all requested information exactly as instructed in the video. Submissions containing missing, incomplete, or incorrect information may result in invalid or incomplete results and could require you to resubmit the form with the correct information. Please review your entries before submitting

Full Name * (required)

Citation Number * (required)

Citation Issued

Date Citation Issued * (required)Date Citation Issued * (required)

Open the calendar popup.

What is the secret pass phrase stated during the video? (if you do not remember the phrase, you will have to watch the video again) * (required)

Once you have successfully submitted the form, you will need to visit the Maricopa Municipal Courthouse to verify your information has been received and sign the completion waiver before your citation fee will be waived.