PETITION FOR RESTORATION OF DRIVING PRIVILEGE – HABITUAL OFFENDER Commonwealth of Virginia Case No. .................................................................................................................... VA. CODE §§ 46.2-358; -359; -360; -361 .................................................................................................................................................................. CITY OR COUNTY HEARING DATE AND TIME General District Court ________________ .................................................................................................................................................................. PETITIONER’S NAME ________________ COMPLETE DATA BELOW IF KNOWN RACE SEX BORN MO. .................................................................................................................................................................. ADDRESS .................................................................................................................................................................. DAY HT. YR. FT. SSN WGT. EYES HAIR IN. STATE VA. D.L. # (IF DIFFERENT FROM SSN) ________________ ________________ ________________ ________________ TO THE JUDGE OF THE ABOVE NAMED COURT: I respectfully represent that I was adjudged to be an habitual offender by the ...................................................................................................... General District Court on ................................................................................... DATE I have attached a certified “Habitual Offender Restoration Transcript” of my driving record from the Department of Motor Vehicles. CHECK ONE BOX AS THE BASIS OF YOUR PETITION: [ ] A. Restoration under Va. Code § 46.2-360(1) (Eligibility only after five (5) years from the date of your adjudication – unless you are entitled to credit under subsection (iii) below.) I have been adjudged to be and habitual offender based in part on and dependent upon convictions of Va. Code § 18.2-266, § 18.2-51.4 or Subsection A of § 46.2-341.24 or valid local ordinance or law of another state or jurisdiction relating to operating a motor vehicle under the influence of intoxicants or drugs. I represent that: (i) At the time of the convictions, I was addicted to or psychologically dependent on the use of alcohol or other drugs; and (ii) At this time I am no longer addicted to or psychologically dependent on the use of alcohol or other drugs; and (iii) Five years have passed from the date on which I was adjudged to be an habitual offender [For the purposes of determining eligibility under this section, I rely on a period of credit for administrative suspension by the Department of Motor Vehicles, pursuant to Virginia Code § 46.2- 391(B) (for third offense drunk driving) prior to adjudication: [ ] Yes [ ] No If yes, period of suspension under § 46.2-391(B): ................................................................. to .......................................................... ]; and (iv) I do not constitute a threat to the safety and welfare of myself or others with respect to the operation of a motor vehicle. I request that the Court restore my privilege to operate a motor vehicle in the Commonwealth upon my evaluation by the Virginia Alcohol Safety Action Program. FORM DC-485 (MASTER, PAGE ONE OF THREE) 4/99 American LegalNet, Inc. www.FormsWorkflow.com [ ] B. Restricted Driver’s License under Va. Code § 46.2-360(2) (Eligibility only after three (3) years from the date of your adjudication – unless you are entitled to credit under (iii) below.) I have been adjudged to be an habitual offender based in part on and dependent upon convictions of Va. Code § 18.2-266, § 18.2-51.4 or Subsection A of § 46.2-341.24 or valid local ordinance or law of another state or jurisdiction relating to operating a motor vehicle under the influence of intoxicants or drugs. I represent that: (i) At the time of my convictions, I was addicted to or psychologically dependent on the use of alcohol or other drugs; and (ii) At this time I am no longer addicted to or psychologically dependent on the use of alcohol or other drugs; and (iii) At least three years have passed from the date on which I was adjudged to be and habitual offender [For purposes of determining eligibility under this section, I rely on a period of credit for administrative suspension by the Department of Motor Vehicles, pursuant to Virginia Code § 46.2- 391(B) (for third offense drunk driving) prior to adjudication. [ ] Yes [ ] No If yes, period of suspension under § 46.2-391(B): ................................................................. to .......................................................... ]; and (iv) I do not constitute a threat to the safety and welfare of myself or others with respect to the operation of a motor vehicle; and I request that the Court order the issuance of a restricted license to allow me to drive to and from work and during the course of my employment, upon evaluation by the Virginia Alcohol Safety Action Program. .................................................................................................................................................................................................................................. NAME AND ADDRESS OF EMPLOYER ......................................................................................................... DAYS AND HOURS WORKED [ ] C. Restoration under Va. Code § 46.2-361(A) (Eligibility only after three (3) years from the adjudication and after all fines, court costs, forfeitures, restitution, penalties and/or judgments have been paid in full.) I have been adjudged to be an habitual offender and such adjudication was not based on any drunk driving conviction(s), but was based in part and dependent upon a conviction of driving while my license or privilege to drive was suspended or revoked where the suspension or revocation was only for: • failure to pay fines, costs, forfeitures, restitution and/or penalties; or • failure to furnish proof of financial responsibility, or • failure to satisfy a judgment. I represent that: (i) At least three years have passed since the date of my adjudication to be an habitual offender. (ii) I do not constitute a threat to the safety and welfare of myself or others with respect to the operation of a motor vehicle. [ ] D. Restoration under Va. Code § 46.2-361(B) (Immediate eligibility after all fines, court costs, forfeitures, restitution, penalties and judgments have been paid.) I have been adjudged to be an habitual offender based entirely upon convictions of driving while my license or privilege to drive was suspended or revoked where the suspension or revocation was only for: • failure to pay fines, costs, forfeitures, restitution and/or penalties; or • failure to furnish proof of financial responsibility; • failure to pay uninsured motorist fee; or • failure to satisfy a judgment. I attach proof that all fines, costs, forfeitures, restitution, penalties and/or judgments have been paid in full, and I attach proof of financial responsibility. I attach proof of motor vehicle insurance or payment of uninsured motorist fee. I represent that I do not constitute a threat to the safety and welfare of myself or others with respect to the operation of a motor vehicle. I request that the Court restore my privilege to operate a motor vehicle in the Commonwealth. FORM DC-485 (MASTER, PAGE TWO OF THREE) 10/07 American LegalNet, Inc. www.FormsWorkflow.com [ ] E. Restoration under Va. Code § 46.2-359 (Eligibility upon reaching eighteen years of age.) I have been adjudged to be an habitual offender based in whole or in part based on findings of not innocent while I was a juvenile. I am now eighteen years of age or older. I request that the Court restore my privilege to operate a motor vehicle in the Commonwealth. [ ] F. Restoration under Va. Code § 46.2-358 (Eligibility only five (5) years from the adjudication where adjudication was based on no drunk driving convictions.) I have been adjudged to be an habitual offender, and at least five years have passed since the date of such adjudication. I represent that I do not constitute a threat to the safety and welfare of myself or others with regard to the operation of a motor vehicle. I request that the Court restore my privilege to operate a motor vehicle in the Commonwealth. I request that the Court hold a hearing on my petition. I understand that the hearing will be held no less than thirty (30) days from the date notice of this petition is served on the Commonwealth’s Attorney and the Commissioner of the Department of Motor Vehicles. I understand that the Commonwealth’s Attorney and the Commissioner of the Department of Motor Vehicles may object to my petition and that the Court may deny my petition to restore my privilege to operate a motor vehicle in the Commonwealth, may deny the issuance of a restricted driver’s license or may place conditions on my privilege to operate a motor vehicle. ............................................................................................................ DATE ____________________________________________________________________________________________________ PETITIONER’S SIGNATURE RETURN – COMMONWEALTH’S ATTORNEY: RETURN – COMMISSIONER OF DMV: SERVED ON SERVED ON .................................................................................... .................................................................................... NAME NAME .................................... _________________________________ .................................... _________________________________ DATE SERVING OFFICER DATE SERVING OFFICER FOR __________________________________________________ FORM DC-485 (MASTER, PAGE THREE OF THREE) 7/98 FOR __________________________________________________ American LegalNet, Inc. www.FormsWorkflow.com