Ventura — Petition for Restricted License (Adult)

Source: https://ventura.courts.ca.gov/system/files/vn172.pdf

VN172

ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and Address) Telephone Number FOR COURT USE ONLY

ATTORNEY FOR (Name):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF VENTURA

800 SOUTH VICTORIA AVE. VENTURA, CA 93009 4353 VINEYARD AVE, OXNARD, CA. 93036

PLAINTIFF: PEOPLE OF THE STATE OF CALIFORNIA

DEFENDANT:

CASE NUMBER: PETITION FOR RESTRICTED LICENSE

13202.5 VC - Controlled Substance or Alcohol Related Offense
(under age of 21 years)

I, the undersigned, say that:

1. I am the defendant in the above-entitled action.

2. My date of birth is: __________________________________________

3. My driver’s license number is: _________________________________

4. I was convicted of a violation of __________________________ on _____________________ and consequently

   my driving privilege was suspended for _______________________ months year(s).

5. My driving privilege is not suspended at this time for any other reason.

6. I have a critical need to drive, as follows: _________________________________________________________

   ---

   ---

   _____________________________________________________________________________________________.

7. Wherefore, I request the court to authorize a restricted license permitting me to do so.

I declare under penalty of perjury that the foregoing is true and correct.

Dated: ________________________________ Signature of Petitioner: ___________________________________ Address: _______________________________ Phone Number : ___________________________________ __________________________

ORDER

The court orders that the petition is: Denied. No critical need has been shown. Granted. DMV to issue a license restricted as follows:

Date: __________________________ Judicial Officer’s Signature ____________________________________

CAUTION: THIS ORDER DOES NOT AUTHORIZE YOU TO DRIVE. YOU MUST GO TO THE DMV AND APPLY FOR A RESTRICTED LICENSE.

Optional Form PETITION FOR RESTRICTED LICENSE VN172 (Rev. 01/24)