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2. This application is ONLY for citations/tickets filed through the Butler County District Court Clerk.  If your ticket states you are to contact or appear in a municipal court, you will need to contact that municipal court to ascertain their diversion application.  If you are unsure, you can contact the Butler County Diversion Coordinator at (316) 321-6999 with the information on your ticket to ascertain where you need to go to apply. Further, if you complete this application and your citation/ticket is not through the Butler County District Court, your $50.00 application fee will not be refunded.

4. YOU MUST APPLY FOR DIVERSION WITHIN TEN (10) BUSINESS DAYS OF YOUR FIRST APPEARANCE DATE OR YOUR APPLICATION WILL BE DENIED!
6. • Application WILL NOT be accepted without payment of a $50.00 non-refundable application fee at the time of filing.
   • Only credit/debit card payment will be accepted for online applications.
   • 1. APPLICANT INFORMATION
   • First Name*
   • Middle Name
   • Last Name*
   • Primary Phone*
   • Alternate Phone
   • Email*
   • Address1*
   • Address2
   • City*
   • State*
   • Zip*
   • Date of Birth*
     Date of Birth
   • Sex*

     1. MALE

     1. FEMALE
   • Race*
     -- Select One --AsianAfrican-AmericanCaucasionHispanicOther
   • Driver's License #
   • Issuing State
   • CDL?

     1. YES

     1. NO
   • If YES, CDL# and Issuing State
   • If you have an attorney representing you regarding this matter, provide name
   • Ticket or Citation Image

     Please upload an image of the citation or ticket. processing of your application may be delayed if an image is not uploaded. 

   • 2. PREVIOUS CRIMINAL ARREST, CONVICTIONS or DIVERSIONS, INCLUDING TRAFFIC TICKETS
   • • Have you ever been detained, arrested or charged with any offense of the law?
     • List ALL arrests, even if no charges were filed.
     • Include any convictions, diversion or deferred prosecution including juvenile offenses.
     • Failure to disclose prior history may result in denial of your application.
   • OFFENSE/EVENT
   • YEAR
   • STATE
   • CONVICTION?
   • 1. YES
     2. NO
   • 1. YES
     2. NO
   • 1. YES
     2. NO
   • 1. YES
     2. NO
   • 3. DO YOU HAVE ANY PENDING CRIMINAL CHARGES OR TRAFFIC CITATIONS PENDING IN KANSAS OR ANY OTHER STATE, COUNTY, OR CITY?
   • 1. YES

     1. NO
   • If yes, where?
   • THE FOLLOWING SECTION IS TO BE COMPLETED IF YOU HAVE BEEN CHARGED WITH A TRAFFIC OFFENSE ONLY
   • VEHICLE INFORMATION
   • Insurance Company
   • Policy Number
   • AGENT NAME & PHONE
   • I hereby apply for status as a participant in the Diversion Program. I request that the Butler County Attorney temporarily delay trial proceedings against me in order to permit the County Attorney’s consideration of this application. I agree that any time taken to consider this application, and the rescheduling for trial, should I be denied, will be assessed against me in determining my right to a Speedy Trial. I understand that the final decision to commence trial proceedings or to defer prosecution in my case rests entirely with the Butler County Attorney.

     
     I authorize the Diversion Coordinator to conduct an investigation to determine suitability for this program. I understand that any information furnished or authorized by me, to be given to the Diversion Coordinator in connection with this investigation, will be kept confidential.

     
     I understand that a false answer to any question in this application, or withholding information requested, may be grounds for recommendation against placement into this program or removal after placement in the program, in which case, the Butler County Attorney will resume prosecution of the original charges. I also understand that the Butler County Attorney may file additional criminal charges against me if I give any false information in this application.
   • Diversion Fee
     Diversion Fee
   • Price
   • Quantity
   • Shipping Cost
   • Taxable
   • Date*
     Date
   • APPLICANT*
   • ATTENTION

     You are about to be redirected to the KanPay processor for payment. When submitting payment, the "Customer Information" must match the information provided on this form. The application for diversion will not be accepted until payment is received. 

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   • 1. Receive an email copy of this form.
   • Email address

     This field is not part of the form submission.

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