Law Offices of Dan Haltenhof, LC

Please fill out the form below. If you are submitting tickets from more than one traffic stop, please submit one form per stop. Once we have received this form, we will contact you to discuss pricing and whether or not we can handle the matter. Click here for a chart explaining the ticket amendment process.

Name Email
Home Phone: Cell Phone:
Address Line1:
Address Line2:
City: State: Zip:
I prefer to be contacted via: I was referred by:

Ticket 1:(if speeding, please indicate how fast (ie 70 in a 55)
Violation: Ticket #:
Ticket 2:
Violation: Ticket #:
Where were the ticket(s) issued?
What is the court date for the ticket(s)

Any points on your driving record? Other pending traffic matters? Anything else you wish to tell us?

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