Power of Attorney
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The undersigned hereby acknowledges service of the summons herein,
waives a hearing in court, pleads guilty to the offense charged in
said summons, and authorizes the Clerk of the Traffic Violations Bureau
of the Incorporated Village of Old Brookville to appear in court for
me, to make such plea of guilty on my behalf and to pay the prescribed
fine using the money enclosed.
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Signed
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Print your name
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Address
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