in this proceeding, you are entitled, at no cost to you, to the provision of certain assistance. Please contact Mary Jaffe, ADA Coordinator in the Administrative Office of the Court., Palm Beach County Courthouse, 205 North Dixie Highway, Room 5.2500, West Palm Beach, Florida, 33401, telephone number (561) 3554380 within two (2)

icipate in this proceeding, you are entitled, at no 'cost to you, to the provision of certain assistance. Please contact the ADA Coordinator in the Administrative Office of the Court, 205 North Dixie Highway, Room 5.2500, West Palm Beach, Florida 33401; telephone number 561-355-2431 within two (2) working days of your receipt of

ticipate in this proceeding, you are entitled, at no cost to you, to the provision of certain assistance. Please contact the ADA Coordinator in the Administrative Office of the Court, 205 North Dixie Highway, Room 5.2500, West Palm Beach, Florida 33401; telephone number 561-355-2431 within two (2) working days of your receipt of

e in this proceeding, you are entitled, at no cost to you, to the provision of certain assistance. lease contact Mary Jaffe, ADA Coordinator in the Administrative Office of the Court., Palm Beach County Courthouse, 205 North Dixie Highway, Room 5.2500, West Palm Beach, Florida, 33401, telephone number (561) 355-4380 within two (2

in this proceeding, you are entitled, at no cost to you, to the provision of certain assistance. Please contact Mary Jaffe, ADA Coordinator in the Administrative Office of the Court, Palm Beach County Courthouse, 205 North Dixie Highway, Room 52500, West Palm Beach, Florida, 33401, telephone number (561)355-4380 within two (2) w

on highway; refusal to submit to breath/blood/erne test). Other Chimer Other: that data CIRCUrf cc: GOLD: State mosey YELLOW: Probation BLUE: Administrative Office of the Court PINK: Defense Counsel DGE GREEN: Defendant Form Circuit ( 7/2007) • 7;; Form 004-D EFTA00178211 IN THE CRIMINAL DIVISION OF THE CIRCUIT

DERED in Opma Coat in Palm Beach County, Florida. dig dot A" • /"" 200; ( ,• • - CIRCUIT MOOR oc OOLD: &MC Asamey YELLOW: Probation BLUE: Administrative Office of the Court PINK: Defense Cassel GREEN: Defendant Form Cite (Rev 7/2007) Fcl9P,P*D EFTA00182150 EFFECTIVE MIA' I, 2007, 4050 IN THE COUNTY COURT OF THE

te in this proceeding, you are entitled, at no cost to you, to the provision of certain assistance. Please contact Mary Jaffe, ADA Coordinator in the Administrative Office of the Court., Palm Beach County Courthouse, 205 North Dixie Highway, Room 5.2500, West Palm Beach, Florida, 33401, telephone number (561) 355-4380 within two (2)

in this proceeding, you are entitled, at no cost to you, to the provision of certain assistance. Please contact Mary Jaffe, ADA Coordinator in the Administrative Office of the Court., Palm Beach County Courthouse, 205 North Dixie Highway, Room 5.2500, West Palm Beach, Florida, 33401, telephone number (561) 355-4380 within two (2