POWER OF ATTORNEY
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The undersigned acknowledges the charge of the offense noted herein,
waives a hearing in court, pleads guilty to the offense charged and authorizes
the Clerk of the Traffic Violations Bureau of the Incorporated Village of
Northport, New York, to appear in court for him to make such plea of guilty
on his behalf and to pay the prescribed fine using the moneys enclosed herewith
or submitted herewith.
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Signed
(Print
Your Name)
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(Write
Your Name)
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Address
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