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Use AOC-CV-352 when defendant's license was revoked for a conviction in another state or in a federal court. Use AOC-CR-340 when imposing an ignition interlock restriction. STATE OF NORTH CAROLINA File No. State Date Of Conviction Sex Race Hair Color Date Of Offense Eye Color Date Of Birth Weight The Court has been furnished a properly executed form DL-123 and is satisfied that the defendant is financially responsible. The defendant has executed form DL-123A and is not required to furnish proof of financial responsibility. a. b. 9. The defendant has been convicted of impaired driving under G.S. 20-138.1; G.S. 20-138.2; G.S. 20-138.3; or the defendant has been convicted of a second or subsequent offense of transporting an open container of alcoholic beverage under G.S. 20-138.7(a); or the defendant has been convicted under G.S. 18B-302(a1); or the defendant has been convicted under G.S. 18B-302(c); Upon application of the defendant for a limited driving privilege, the Court finds that: FINDINGS 1. At the time of the offense, the applicant held either a valid drivers license or a license that had been expired for less than one (1) year; 2. 3. 4. At the time of the offense, the defendant had not within the preceding seven (7) years been convicted of an offense involving impaired driving; Punishment level three, four, or five has been imposed upon the defendant for the offense of impaired driving, or the defendant has been convicted under G.S. 20-138.3, or the defendant has been convicted of a second or subsequent offense under G.S. 20-138.7(a), or the defendant has been convicted under G.S. 18B-302(a1), or the defendant has been convicted under G.S. 18B-302(c); 5. Subsequent to the offense, the defendant has not been convicted of, or had an unresolved charge lodged against the defendant for, an offense involving impaired driving; 6. 7. If convicted only under G.S. 20-138.3, the defendant was 18, 19 or 20 years old on the date of the offense and has not previously been convicted of a violation of G.S. 20-138.3; ( NOTE: Even if the defendant was 18, 19 or 20 years old at the time of the offense, he/she may not receive a limited driving privilege if his/her current conviction was under either (1) G.S. 20-138.1 or (2) both G .S. 20-138.1 and G.S. 20-138.3.) 8. The records of the Division of Motor Vehicles and the Clerk of Superior Court in this county have been searched, and there are no other revocations in effect at this time; The defendant has obtained and filed with the court a substance abuse assessment; STATE VERSUS Drivers License No. Original - File Certified Copy - Applicant Copy - DMV (Over) County LIMITED DRIVING PRIVILEGEIMPAIRED DRIVIN G OR OPEN CONTAINER OR UNDERAGE ALCOH OL VIOLATION (N.C. CONVIC TIONS ONLY) G.S. 20-17.3, 20-179.3, 20-138.3(d), 20-138.7(h) In The General Court Of Justice District S uperior Court Division Name And Address Of Defendant AOC-CR-312, Rev. 10/15 © 2015 Administrative Office of the Courts ORDER It is ORDERED that the defendant be allowed a limited driving privilege to be effective on the date indicated below to be used in accordance with the restrictions imposed on the reverse of this form, and to expire one year from the date on which the Division of Motor Vehicles revokes the defendant's drivers license pursuant to G.S. 20-17(a)(2), G.S. 20-13.2(a), G.S. 20-17(a)(12), or G.S. 20-17.3. This limited driving privilege is conditioned upon the maintenance of any financial responsibility required by G.S. 20-179.3(l) during the period of this privilege. Signature Of Judge Name Of Judge (Type Or Print) NOTE TO DEFE NDANT: This privilege is no longer valid after the revocation period for the offense of which you were convicted has ended, or if your drivers license remains revoked solely because the Division of Motor Vehicles has not obtained a certificate of your completion of a substance abuse treatment program or an alcohol and drug education traffic school. Date Effective Date NOTE: Height Driving is restricted to: CERTIFICATION Deputy CSC Clerk Of Superior Court NOTICE/ ACKNOWLEDGMENT OF RECEIPT I certify tha t this is a true and complete copy o f the or iginal on f ile in this case. Date Date Signature Signature Of Defendant Assistant CSC any non-commercial vehicle r egistered in the name of the driver. the f ollowing non-commercial vehicle(s): a. b. RESTRICTIONS 1. Driving is permitted for work-r elated, religious wors hip, or educational purposes dur ing standard working hours as f ollows: The driver shall not drink alcohol while driving or drive while any alcohol remains in his/her body. The driver shall not drive while having a contr olled substance in his/her body unless such contr olled substance was lawfully obt ained and taken in ther apeutically approved amounts. This limited driving privilege DOES NOT include the privilege of operating a commercial motor vehicle as def ined in G.S. 20-4.01(3d). Driving when essential for emergency medical care is authoriz ed at any time. St andard working hours are from 6 AM to 8 PM, Monday - Fr iday. Driving other t han for emergency medical care is permitted only as follows: (check only applicable boxes.) 4. Driving is permitted for work-r elated, religious worship, or educational purposes dur ing nonst andard working hours as follows. 3. 6. Addit ional restrict ions: 5. Corrective Lenses 45 M.P.H . Only Dayligh t Only Other: Driving is permitted for community service assignmen t, Alcohol and Drug Educat ion Traffic School, and substance abuse assessment or t reatment as follows: The driver is self employed and the required documentat ion for work-related driving is attached. 2. Driving is permitted for maint enance of household dur ing standard working hours as follows: Name And Address Of ADET School, Community Service Coordinator, Or Mental Health Treatment Facility To Which Driver Assigned Name And Address Of Employer Or Driver's Place Of Work AOC-CR-312, Side Two, Rev. 10/15 © 2015 Administrative Office of the Courts I have received a copy of this limited driving privilege which contains \ the restrictions on my driving privilege. I understand that if I drive with the odor of alcohol on my breath, I may be subject \ to arrest and loss of this limited driving privilege; I understand that this is my limited license to drive; that I must keep it\ in my possession during the period of revocation; that if my drivers license is revoked for any other reason, this limited driv\ ing privilege is invalid; that a violation of any restriction imposed in connection with this limited driving privilege constitutes th\ e offense of driving while license revoked under G.S. 20-28; that if community service has been ordered, my willful failure to\ pay the prescribed fee or complete the community service within the time limit imposed shall result in revocation of this\ limited driving privilege; and that my willful failure may also result in other action authorized by law for violation \ of a condition of probation.

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