INFORMA TION SHEET FOR L IMITED DRI VING PRIVI LEGE PET ITION NOTICE: You may be able to apply for limited driving privileges although your driver license is suspended. Please review the information contained on this page. If you believe that you meet the requirements, follow the instructions below. The court cannot give you privileges IF: You have had more than one prior suspension within the past 5 years for NOT having insurance coverage; or You have had a twelve (12) point suspe nsion in the last five years; or You have not paid for damages you caused in a motor vehicle accident. To receive limited driving privileges, you must do ALL of the following: 1. Pay for damages you caused if you were involved in a motor vehicle accident; 2. Obtain approved financia l responsibi lity (INSURA NCE) coverage , (means one of the following: a. An SR-2 2 Insurance or Surety Bond (must be obtained from a commercial insurance company.) b. A $60,000.00 real estate bond which may be obtained through the BMV, or c. A cash deposit of $30,000.00 which must be deposited with the BMV. 3. Pay all reinstatem ent fees unless you are applying for an extension payment plan and agree to pay all fees within no more than 180 days. 4. Fill out and sign the PETITION and INFORMATION SHEE T in this packet, along with copies of all requested information listed on the bottom of information sheet. 5. Bring or mail the petition (2 copies if you want one back) and the appropriate filing fee as listed in the petition form to: Cleveland Heights Municipal Court 40 Severance Circle Cleveland Heights, OH 44118 WAR NING: There may be a hard time period in which you cannot receive limited driving privileges of up to 15 days. 04/2005 Civilpetition04info American LegalNet, Inc. www.USCourtForms.com>>>> 2 IN THE CLEVELAND HEIGHTS MUNICIPAL COURT ______________________________ Case No________________________ Name of Petit ioner BMV Case No.___________________ ______________________________ Fu ll Str eet addre ss w ith Apt. # Policy No.______________________ ______________________________ Date of Birth____________________ Cit y/State /Zip Social Secu rity #_____________________________ Phone # with ar ea co de OUT OF STATE DUI 5. SUSPENSION P ETITION Registrar, B ureau of Motor Vehicles Drivers Licen se Division P.O. Box 16520 Columbu s, OH 43266-0020 I hereby appeal the attached notice of suspension from the Bureau of Motor Vehicles for the following reason(s): __________________________________________ _______________________________ __________________________________________ _______________________________ __________________________________________ _______________________________ __________________________________________ _______________________________ __________________________________________ _______________________________ __________________________________________ _______________________________ __________________________________________ ___ Attach Notice from Bureau of Motor Vehicles and civil petition for driving privileges form. ___________________________________ Signature of Petitioner Date______________________________ _ Civil DUI Petition American LegalNet, Inc. www.USCourtForms.com>>>> 3 INF ORMATI ON FOR DRI VING PRI VIL EGES Must accompany any BMV P etition Name: Case # Employer Name: Phone: Employer Address: City: State: Zip: I work the following schedule: DAYS OF WEEK STARTING TIME QUITTING TIME Monday Tuesday Wednesday Thursday Friday Saturday Sunday I drive in the course of my employment: ___ Yes ___ No I need other driving privileges for the following necessities: PURPOSE LOCATION DATE TIME CHEC K OFF AND ATTACH THE FOLLOWING: 9 BMV Notice of Suspension 9 Receipt for BMV Payment 9 Letter from employer 9 Copy of insurance card or declarations page valid for at least 90 days Civilpetitiondriving 01/2004 American LegalNet, Inc. www.USCourtForms.com