CR-741 (6/18)(cs) AS 28.15.201(h) REQUEST FOR HEARING ON IN THE SUPERIOR COURT FOR THE STATE OF ALASKA AT STATE OF ALASKA ) Plaintiff, ) vs. ) CASE NO. CR ) ) REQUEST FOR HEARING ON PROOF Defendant. ) INSTRUCTIONS: This procedure is not available in Anchorage, Bethel, Fairbanks, Juneau, Kenai, or Palmer. This procedure is only available if you have a past felony conviction for operating a vehicle under the influence of alcohol or a controlled substance (AS 28.35.030). It is not available if your conviction was for refusing to submit to a chemical test (AS 28.35.032).I, , had my license revoked for a felony conviction under AS 28.35.030. I request a hearing to show I may be eligible Date City State ZIP Daytime Phone Hearing ordered. Date: Time: Courtroom: Request denied. Date Judge I certify that on a copy of this order was given or sent to: American LegalNet, Inc. www.FormsWorkFlow.com