For Clerk Use Only Hamilton County Municipal Court

Date ______Clerk of Courts, Civil Division 1000 Main Street, Room 115 Room: 236 Cincinnati, Ohio 45202

Time: 9:00am

______Case: ______Petitioner

Vs.

State of Ohio Application for driving privileges on Bureau of Motor Vehicles a BMV Non-Compliance suspension and/or fee payment plan.

Now comes the Petitioner in the above captioned case and respectfully represents to the court that the said Petitioner’s driver license is suspended due to Non-compliance suspension and/or BMV reinstatement fees owed.

The Petitioner further states that the continued suspension of the privilege to operate a motor vehicle would cause an extreme hardship, the Petitioner is now requesting modified driving privileges.

I, the Petitioner, understand I will be required to provide a current insurance card and proof of employment/school on scheduled court date

______Petitioner/Attorney (signature) ATTY. I.D. Date

______Address Social Security Number

______City, State, Zip Code Driver License Number

______Telephone Date of Birth

Get to the courthouse a half hour before your court time to get through security. HAMILTON COUNTY MUNICIPAL COURT CINCINNATI, OHIO

Instructions-Please Read

BMV Non Compliance Suspension/Fee payment plan Complaint for Driving Privileges Ohio Revised Code 4509.101

Your Driver License has been suspended for failing to comply with the Financial Responsibility Laws or you are under a court suspension and you owe BMV reinstatement fees and want to be on a payment plan.

You are here to file the Complaint for Driving Privileges.

You must file the appeal in your county of residence. Only Hamilton County, Ohio residents may file an appeal/complaint for driving privileges here in the Hamilton County Court.

The cost of the appeal is $116.00

On the day of court you must present your automobile insurance, proof of employment, school schedule and/or proof of all other vocational purposes.

If granted, you must take the Court Order driving privileges to the BMV Ohio Regional Service Center at 10948 Hamilton Ave, Monday thru Friday, 8:00 am to 4:30 PM, to be recorded on your record BEFORE you may drive. At that time the BMV will issue you a letter to renew or test if needed.

PETITIONER COPY

2015