STATE OF MINNESOTA DISTRICT COURT COUNTY OF HENNEPIN FOURTH JUDICIAL DISTRICT _______________________________ Petitioner WAIVER OF HEARING Vs. Commissioner of Public Safety File No.______________________ Respondent _____ The petitioner was represented by ________________________________________ Esq. _____ The petitioner is pro-se. Petitioner hereby withdraws the petition for review filed pursuant to Minnesota Stat 169A.53s2 and 3. ____________________________________ Attorney for Petitioner/Pro-Se Petitioner Dated: _____________________ Revised 9/04 American LegalNet, Inc. www.FormsWorkflow.com