52-3 District Court
700 Barclay Circle
Rochester Hills, Michigan 48307
Note: Complete this request for CIVIL INFRACTIONS only. You cannot request a hearing if today's date is past the due date listed on your ticket. Upon submission of this form for a civil infraction, please do not call the court to schedule a hearing or send in your copy of the ticket.

To request a hearing on a MISDEMEANOR, you must read the back of your ticket, plead not guilty on the back, sign it and return it to the court at the address above.

Note: Required fields are marked with an "*".
Additional Addr.:
City:*  State:*   Zip: *  
Day Time Phone:   E-mail: *  
Ticket Number: *   Ticket Date: *  
Police Agency:*  
Description of Offense:*  
Type of Hearing Request:* Informal Hearing - Before the Magistrate;
Formal Hearing - Before a Judge.