Legal Restricted License Petition

LEGAL RESTRICTED LICENSE PETITION

Petitioner: (hereinafter "Petitioner") hereby petitions the located in County, , against Respondent: for an order granting a restricted driver's license and related relief.

RECITALS

WHEREAS, Petitioner is the holder of driver's license number and that license was suspended or revoked effective for reasons set forth in the administrative action or conviction noted in the record;

WHEREAS, Petitioner requires limited driving privileges to maintain employment, obtain medical care, or otherwise prevent undue hardship, and Petitioner can satisfy reasonable conditions imposed by the Court to ensure public safety;

WHEREAS, Petitioner has prepared documentation in support of this petition and requests judicial review and an order granting a restricted license consistent with public safety and statutory authority.

NOW, THEREFORE

Petitioner respectfully requests that the Court enter an order as set forth below and asserts the following factual allegations and legal basis in support thereof:

1. JURISDICTION AND VENUE

1.1 This Court has jurisdiction over this Petition under the laws and regulations governing motor vehicle licensing and the Court's general equity jurisdiction to fashion appropriate relief for hardship and public safety. Venue is proper in this County because Petitioner resides or maintains principal employment within this County: .

2. STATEMENT OF FACTS

2.1 Petitioner was lawfully convicted or administratively cited on which resulted in suspension or revocation of driving privileges. The action was recorded as: .

3. GROUNDS FOR RELIEF

3.1 Petitioner alleges that good cause exists to grant limited driving privileges where the public interest and Petitioner’s need can be balanced by appropriate conditions. Petitioner is prepared to comply with conditions including but not limited to maintenance of insurance, proof of continuous compliance with alcohol-related conditions where applicable, and limitations on hours, routes, and purposes for driving.

4. RELIEF REQUESTED

Petitioner requests that the Court enter an order that includes the following specific relief:

Employment: travel to and from workplace
Medical appointments and treatment
Education and vocational training
Household and family care responsibilities
Other (specify):

Permitted days/hours:
Distance limitation from residence or workplace:
Vehicle(s) permitted: Make/Model/Plate:

Petitioner further requests that any restricted license be conditioned upon the following (check applicable):

Filing and maintenance of SR-22 or equivalent proof of financial responsibility
Installation of ignition interlock device as ordered
Periodic proof of compliance to the Court (reports to be determined by Court)
Compliance with alcohol monitoring, counseling or treatment as ordered

5. SUPPORTING DOCUMENTS

Petitioner has attached the following documents in support of this Petition and will submit originals upon request by the Court:

Employment verification or letter from employer
Medical documentation supporting need for travel
Proof of insurance or anticipated insurance (binder)
Certified driving history or administrative record
Other attachments:

6. NOTICE AND SERVICE

6.1 Petitioner requests that the Court provide notice of any hearing to the Respondent at the following address for service:

7. PROPOSED ORDER

7.1 Petitioner proposes that the Court enter an order granting a restricted license limited to the purposes and conditions outlined herein for a period of subject to review and modification by the Court upon motion or notice of noncompliance.

8. VERIFICATION AND CERTIFICATION

Petitioner certifies under penalty of perjury under the laws of the State that the foregoing statements are true and correct to the best of Petitioner’s knowledge and that Petitioner will notify the Court promptly if any material fact changes prior to entry of any order.

9. MISCELLANEOUS PROVISIONS

Governing Law: This Petition and any order issued pursuant hereto shall be governed by the laws of the State of .

Entire Agreement: The terms requested in this Petition constitute the entire agreement of Petitioner with respect to the matters herein and supersede any prior proposals or informal agreements.

Severability: If any provision of any order entered herein is found invalid or unenforceable, such provision shall be severed and the remaining provisions shall remain in full force and effect.

Amendment and Waiver: This Petition may be amended by written filing. No waiver of any provision shall be effective unless in writing and signed by the waiving party and approved by the Court.

Counterparts: This Petition may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one instrument.

SIGNATURES

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