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Driver's License Reinstatement Form
_______________________, ________, I [ ] plead guilty to
OR [ ] was found guilty of a theft-related offense.
I was convicted and sentenced to pay restitution in the amount of $_________________________________.
I hereby swear and affirm that I have repaid the restitution owed in full. Wherefore, the Defendant prays the Court enter
an Order directing the reinstatement of his/her driver's license.
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