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Citation Form
Agency Name:
(Required)
Enter a zero (0) if it does not apply.
Number Of Teen (Age 14-17) Seat Belt Citations:
(Required)
Number Of Adult Seat Belt Citations:
(Required)
Number Of Child Restraint Citations:
(Required)
Other Notable Citations:
(Required)
Number Of Enforcement Hours Worked:
(Required)
Number Of Officers Who Worked:
(Required)