Fill and Sign the Mississippi Hardship 497314283 Form

IN THE CIRCUIT COURT OF       COUNTY, MISSISSIPPI       PETITIONER VS. NO.       MISSISSIPPI DEPARTMENT OF PUBLIC SAFETY RESPONDENT PETITION FOR HARDSHIP COMES NOW the Petitioner,       , and petitions this Court to reduce the suspension of Petitioner's driving privileges and in support thereof would show unto the Court the following, to - wit: 1. The Petitioner,       , is an adult resident citizen of       County, Mississippi, residing at       ,       , Mississippi       . The Respondent, Mississippi Department of Public Safety, is a State of Mississippi governmental entity. 2. The Petitioner had his/her driving privileges suspended for       (       ) days on             ,       , pursuant to a conviction on             ,       , for Driving Under The Influence (       Offense) in             Court,       ,       County, Mississippi. Said driving privileges were suspended pursuant to § 63 - 11 - 30 (2)(a), Miss. Code Ann, (1972) as Amended, (Implied Consent Law). 3. The Petitioner is a first offender under the Implied Consent Law, being § 63 - 11 - 30 (2)(a), Miss. Code Ann, (1972) as Amended, and effective       ,       , his driving privileges will have been under suspension for a period of       (       ) days under § 63 - 11 - 30 (2)(a). 4. The Petitioner's Mississippi driver's license number is       . 5. The Petitioner's address is       ,       , Mississippi       ; date of birth is             ,       ; color of hair is       ; color of eyes is       ; weight is       ; height is       ; social security number is       . 6. The Petitioner will complete the Mississippi Alcohol Safety Education Program (MASEP) as provided in § 63 - 11 - 32, Miss. Code Ann, (1972) as Amended. 7. The specific facts which constitute a hardship are that the Petitioner's employment is contingent upon his/her possession of a valid Mississippi driver's license. If the Petitioner is not allowed to possess a driver's license, his/her employment may be terminated causing severe financial hardship upon the Petitioner and his/her family. Wherefore, Petitioner requests that this Court reduce the suspension of Petitioner's driving privileges and allow him/her possessing a valid Mississippi driver's license. Respectfully submitted, _______________________________________       Attorney for       Of counsel:                         Telephone:       MSB #       Attorney for       STATE OF MISSISSIPPI COUNTY OF       PERSONALLY CAME AND APPEARED BEFORE ME, the undersigned authority in and for the jurisdiction aforesaid, the within named       , Petitioner, who, after being first by me duly sworn stated that the matters, facts, and averments contained and set forth in the above and foregoing Petition are true and correct as therein stated. SWORN TO AND SUBSCRIBED BEFORE ME this the       day of       ,       . ____________________________________________ NOTARY PUBLIC Commission Expires: