Central Violations Bureau

This form is to pay a violation notice received on Federal property. You may pay your fine in lieu of appearance in court, if Box "B" is checked on your citation. You must appear in court if Box "A" is checked. Contact the Central Violations Bureau if you have any questions at (800) 827-2982.

Defendant Last Name
Defendant First Name
Defendant Middle Initial
Daytime Phone Number
Address 1
Address 2
City
State
Zip Code
CVB Location Code	(4 characters maximum)
Violation Number	(One alpha character followed by 6 or 7 numbers)
Total Colateral Due
Card Type	Visa Master Card	Discover American Express
Card Number
Expiration Date	(Enter as mm/yy)
Print Name of Cardholder
Cardholder Phone Number
Cardholder Signature
Payment Mailing Address	Central Violations Bureau P.O. Box 71363 Philadelphia, PA 19176-1363
Note: Charges will appear as "US COURTS CVB 8008272982" on your credit card statement