Respondent's Plea

Texas Department of Agriculture

NOTE: If you fail to respond to your Notice of Violation within twenty (20) days after its issue date by requesting a hearing, you will lose your right to a hearing and a default order will be issued.

Respondent's Plea *

1. Respondent does not contest the alleged violation, but requests a hearing on the penalty amount. 2. Respondent requests a hearing on both the alleged violation and the penalty amount.

A person executing this document on behalf of the business or individual named in the Notice of Violation and citation certifies that she or he is authorized to do so.

TDA Case or Incident No. *

If you have more than one violation in your case, please list each violation number you're requesting a hearing on. You can request a hearing on one or multiple violations in your case.

Full Name *

First Name Last Name

Phone Number

Area Code Phone Number

Title *

TDA License No.

Phone Number *

Area Code Phone Number

E-mail *