IN THE MAUMEE MUNICIPAL COURT _____________________________________________ _____________________________________________ _____________________________________________ Petitioner -vsFranklin R. Caltrider, Registrar Ohio Bureau of Motor Vehicles P.O. Box 16520 Columbus, Ohio 43216-6520 Respondent Case No. ______________ PETITION OF APPEAL Now comes the Petitioner, _______________________________, and states that he/she resides in the jurisdiction of the Maumee Municipal Court, and that he/she is an adult. Petitioner further states that on __________________________, ___________, there was mailed to him/her at his/her last known address, a notice in accordance with the provisions of Section 4510.037 of the Ohio Revised Code, stating that his/her driving privileges would be suspended effective _______________________, __________, said notice alleging that Petitioner had not less than twelve (12) points charged against him/her within a period of two (2) years for traffic violations. Petitioner states that he/she agrees to pay all costs of this proceeding. Petitioner alleges that he/she can show cause why his/her driving privileges should not be suspended. Petitioner has attached to this petition and marked as "Exhibit A" a copy of said Notice of Suspension. Wherefore, _______________________________________, prays that the order of the Bureau of Motor Vehicles suspending his/her driver's license be set aside and held for naught and that his/her driving rights be restored. ________________________________________________ Petitioner/Petitioner's Attorney Telephone No. ____________________ CERTIFICATION This is to certify that a copy of the foregoing has been mailed by ordinary U.S. mail this ________ day of _________________________, ___________, to Franklin R. Caltrider, Registrar, Ohio Bureau of Motor Vehicles, P.O. Box 16520, Columbus, Ohio 43216-6520. _______________________________ Petitioner/Petitioner's Attorney American LegalNet, Inc. www.FormsWorkFlow.com