ATTORNEY OR PARTY WITHOUT ATTORNEY (Name & Address): FOR COURT USE ONLY Telephone No.: E-Mail Address (Optional): ATTORNEY FOR (Name): Fax No. (Optional): Bar No: SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE CENTRAL JUSTICE CENTER: 700 Civic Center Dr. West, Santa Ana, CA 92701 PETITIONER: RESPONDENT: Director of the Department of Motor Vehicles PETITION FOR ALTERNATIVE WRIT OF MANDATE CCP � 1094.5 TO SET ASIDE SUSPENSION OR REVOCATION OF LICENSE � NON DUI STAY REQUESTED Unlimited Civil Mark all 1. boxes that apply CASE NUMBER: Petitioner (full name), is a resident of the County of Orange, State of California at the time this petition is filed. , 2. Respondent, Director of the Department of Motor Vehicles, is the Chief Executive Officer of the Department of Motor Vehicles, a government agency of the State of California, hereafter referred to as "the DMV". At all times prior to the suspension or revocation of petitioner's license, petitioner was the holder of a valid California driver's license, license number vehicle sales person license, license number (if any) other license (describe and provide license number, if any) issued by the DMV. 3. 4. On (date) , an administrative hearing was held. transcript of the administrative hearing has been ordered from the DMV and has been lodged with the Court. will be lodged with the Court as soon as it is received by petitioner. No administrative hearing was held. A certified copy of the 5. On (date) , the DMV issued an Order of Suspension or Revocation of petitioner's license. A copy of the DMV's Order is attached to this Petition. Page 1 of 3 Approved for Optional Use L-0203 (Rev. July 1, 2008) PETITION FOR ALTERNATIVE WRIT OF MANDATE CCP � 1094.5 TO SET ASIDE SUSPENSION OR REVOCATION OF LICENSE � NON DUI CCP 1094.5(g) American LegalNet, Inc. www.FormsWorkflow.com PETITIONER: RESPONDENT: Director of the Department of Motor Vehicles 6. CASE NUMBER: This petition is further based on the following evidence and matters from the record of the administrative hearing [attach additional pages if necessary]. 7. Petitioner is beneficially interested in this action because petitioner is a party directly affected by the action of the DMV in suspending or revoking his or her privilege to operate a motor vehicle. Petitioner needs his or her license to drive to and from and in connection with his or her employment, as well as personal needs. to engage in business for his or her livelihood. Unless the Order of the DMV is stayed, he or she will suffer irreparable damage and injury. 8. Page 2 of 3 Approved for Optional Use L-0203 (Rev. July 1, 2008) PETITION FOR ALTERNATIVE WRIT OF MANDATE CCP � 1094.5 TO SET ASIDE SUSPENSION OR REVOCATION OF LICENSE � NON DUI CCP 1094.5(g) American LegalNet, Inc. www.FormsWorkflow.com PETITIONER: RESPONDENT: Director of the Department of Motor Vehicles 9. CASE NUMBER: As required by California Rule of Court, rule 3.1142, a copy of Petitioner's driving record from the DMV is attached to this petition. Petitioner does not have a speedy and adequate remedy at law because there is no appeal from the DMV's order suspending or revoking the privilege to operate a motor vehicle. Petitioner's only method of review of that order is by writ of mandate in this Court. Petitioner's license is not suspended or revoked for any reason other than those stated in this petition. 10. 11. Petitioner prays that: 1. An alternative writ of mandate issue under the seal of the Court commanding respondent Director of the DMV to set aside and revoke the DMV's order suspending or revoking petitioner's license or to show cause before the Court at a time and place hereafter to be specified by the Court why it has not done so, and why a peremptory writ should not issue. Pending the hearing and final judgment of the Court in this matter, the DMV be ordered to stay the operation of the order suspending or revoking petitioner's license. Other (Describe): For such and further relief as the Court may deem proper. 2. 3. 4. Dated: (Type or Print Name) (Signature of Petitioner) VERIFICATION STATE OF CALIFORNIA) COUNTY OF ORANGE) ss. I, the undersigned, declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on (date) at , California. (Signature of Petitioner) Page 3 of 3 Approved for Optional Use L-0203 (Rev. July 1, 2008) PETITION FOR ALTERNATIVE WRIT OF MANDATE CCP � 1094.5 TO SET ASIDE SUSPENSION OR REVOCATION OF LICENSE � NON DUI CCP 1094.5(g) American LegalNet, Inc. www.FormsWorkflow.com