Fill and Sign the Operators Petition for Court Form

OPERATOR'S PETITION FOR COURT REVIEW OF RMV LICENSE SUSPENSION FOR CHEMICAL TEST REFUSAL CIVIL DOCKET NO. (court use only) Trial Court of Massachusetts District Court Department This petition for review may be filed in the appropriate District Court \ division only after the operator has appeared at the RMV for a license suspension hearing and the RMV has issued a decision. It must be filed w\ ithin 30 days after issuance of the Registrar’s final determination (\ G.L. c.90,§24[1][g]), along with a filing fee of $195 (G.L. c.262,§§\  2, 4C) unless waived for indigency (G.L. c.261,§§ 27A-29)\ . The statute requires that the Court’s review be limited to“the record established at the hea\ ring before the registrar”(§24[1][g]) and therefore the operator\ may not introduce additional evidence before the Court. Pursuant to G.L. c. 90,§24(1)(g), I request court review of the d\ ecision of the Registrar of Motor Vehicles upholding the suspension of my license, permit or right to operate a motor vehicle under G.L. c. \ 90,§ 24(1)(f)(1) based on my alleged refusal to submit to a chemical test or analysis of my breath or blood at the time of my arrest\ for operating a motor vehicle while under the influence of intoxicating liquor. This proceeding is civil in nature and is not part of the underlying cr\ iminal OUI case. Please review that the petitioner has provided all the information required above and then complete this portion of this form. \ Fax a photocopy of this form immediately to the Registry of Motor Vehicles Suspension Department at (857) 368-0019. By way of appearance\ and answer, the RMV will forward copies of the RMV hearing record to the court and to the operator within 15 days. A judge must then revie\ w this petition“as soon as possible”and no later than 30 days afte\ r the petition is filed (G.L. c.90§24[1][g]). RMV questions may be direct\ ed to (857) 368-8207 FOR COURT CLERK'S USE ONLY OPERATOR'S NAME DATE OF BIRTH LICENSE NO. STATE ISSUING LICENSE DATE OF ARREST POLICE DEPT. DATE OF RMV HEARING DATE OF RMV DECISION DATE SIGNATURE OF OPERATOR X DATE & TIME OF SCHEDULED COURT REVIEW (within 30 days from filing of pe\ tition) COURT NAME & ADDRESS COURT EMPLOYEE'S NAME CLERK'S OFFICE FAX NO. DATE FAXED TO RMV (keep FAX confirmation in file) COURT EMPLOYEE'S PHONE NO. & EXTENSION DATE JUDGE'S SIGNATURE JUDGE'S PRINTED NAME DECISION OF THE COURT (To be completed by Judge after court review) This Court’s review is limited to“the record established at the he\ aring before the registrar”(G.L. c.90,§24[1][g]). The Registrar \ has relied on the submission of that hearing record, including the hearing o\ fficer’s decision, for its appearance and answer in this matter. After review of that hearing record, I find as follows: The Registry exceeded its constitutional or statutory authority. (If yes, see specific findings below.) The Registry made an erroneous interpretation of the law. (If yes, see specific findings below.) The Registry acted in an arbitrary and capricious manner. (If yes, see specific findings below.) The Registry made a determination which is unsupported by the evidence i\ n the record. (If yes, see specific findings below.) YES NO SPECIFIC FINDINGS: Accordingly, it is ORDERED that judgment shall enter: AFFIRMING REVERSING the Registrar's determination: DISMISSING the petition for review because it was not timely filed. DISMISSING the petition for review because the petitioner failed to appear, the Registry’s hearing record serving as its appearance and answer. CLERK-MAGISTRATE: Please FAX the result of the judicial review to the RM\ V immediately at (857) 368-0019 X http://www.mass.gov/courts/courtsandjudges/courts/districtcourt/forms.ht\ ml (07/2012)