I need to ask the judge to accept my certificate once more so my insurance rates will go back to their normal cost. Example: If you were speeding 40 mph in a 30-mph zone - you would figure.You must refer to the schedule shown on the reverse side of this letter to determine the total amount of your fine(s) and costs assessed against you. I need any recommendation about this letter below. Documents and Forms. Template of Payment Plan Request with information needed to be filled out highlighted in yellow. "I was wondering what options you have for deferring my sentence Your Honor. Order in the court shall be maintained at all times. First, you must fill out the citation reply form. BY MAIL: Complete the Mail Appearance Form on reverse side, along with a Money order and copy of your citation to the Court indicated BEFORE the.