"POWER OF ATTORNEY: The undersigned pleads guilty to the charge
noted herein and encloses herewith the sum of $_____ cash, check or
money order to pay the necessary fine (circle the one used).
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I hereby appoint the Clerk of the Suffolk County Traffic and
Parking Violations Agency as my attorney-in-fact to appear for me
in said Agency, to waive a hearing on such violation(s), to enter
a plea of guilty on my behalf and to pay the fine.
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_________________________
PRINT NAME
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_________________________
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SIGNATURE
_________________________
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NOTARY
_________________________
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