IN THE MUNICIPAL COURT OF TOLEDO, LUCAS COUNTY, OHIO Petition for BMV Show Cause Hearing for (12) Point Suspension _____________________________ Name _____________________________ Address _____________________________ City, State and Zip _____________________________ Telephone Number Two of the four identifiers below are required. _____________________________ BMV Case Number _____________________________ Driver's License Number _____________________________ Date of Birth XXX - XX _____________________________ Last Four Digits of Social Security -vs- State of Ohio Bureau of Motor Vehicles P.O. Box 16520 Columbus, Ohio 43216-6520 Now comes _______________________, and states that he/she received a letter suspending their (petitioner) driver's license effective on _________________________. (date) Petitioner can show why the suspension should be set aside or modified. Petitioner agrees to pay the costs. Petitioner asks that Defendant/Registrar send to Plaintiff a copy of points accumulated. _____________________________________ Petitioner/Attorney Signature ______________________ Date American LegalNet, Inc. www.FormsWorkFlow.com