IN THE MAUMEE MUNICIPAL COURT _____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________ Petitioner Re: Case No(s). (if known): ____________________________ ____________________________ ____________________________ Case No. ____________________ PETITION TO ESTABLISH PAYMENT PLAN FOR REINSTATEMENT FEES OWED TO BUREAU OF MOTOR VEHICLES 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 he/she owes reinstatement fee(s) to the Bureau of Motor Vehicles in the sum of $_______________________ for which he/she is under suspension. Petitioner further states that, pursuant to Section 4510.10(B) O.R.C., he/she would like to establish a reasonable payment plan of not less than $50.00 per month, to be paid to the Bureau of Motor Vehicles in all succeeding months (not to exceed 180 days) until all reinstatement fees required are paid in full. Petitioner further states that he/she agrees to pay all costs of this proceeding. Petitioner further states that he/she (but for the payment of the reinstatement fees) otherwise would be entitled to operate a vehicle in this state or to obtain reinstatement of his/her operating privileges. Petitioner requests that he/she be granted limited operating privileges in order to enable him/her to reasonably acquire the delinquent reinstatement fees due and owing. Wherefore, Petitioner prays that a reasonable payment plan of at least $50.00 per month be established to be paid to the Bureau of Motor Vehicles in all succeeding months (not to exceed 180 days) until all reinstatement fees required are paid in full. _________________________________ Petitioner/Petitioner's Attorney Telephone No. ____________________ Social Security Number: Driver’s License Number: Date of Birth: ____________________________ ___________________________ ____________________________ American LegalNet, Inc. www.FormsWorkFlow.com