Form Dc-1020 - Application To Modify Failure To Comply
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1
2Division of Vehicles
Central Office Operations
PO Box 12021
Phone: 7852963671
915 SW Harrison St
FAX: 7852966851
Topeka KS 666122021
Nick Jordan, Secretary
Sam Brownback, Governor
Department of Revenue
Donna Shelite, Director of Vehicles
APPLICATION TO MODIFY FAILURE TO COMPLY (K.S.A. 82110) SUSPENSION TO RESTRICTED DRIVING
PRIVILEGES
You may apply to the Division of Vehicles for a determination on whether you are eligible to have your driving suspension for
failure to comply modified to a driving restriction for limited purposes. To be eligible for this modification to driving
restrictions, you must meet the following criteria: 1) you must be licensed in Kansas; 2) your driver’s license is not expired;
3) your driving privileges are not currently withdrawn for other violations that are unrelated to your failure to comply; 4) your
driving privileges are not withdrawn for failure to comply with violations in another state/jurisdiction; and 5) your driving
record does not contain a stayed suspension period originating from a driving while suspended conviction. A nonrefundable
$25.00 application fee must accompany each and every written request for restricted privilege. Fees must be paid to the
Division of Vehicles.
You will receive written notice of your application being approved or denied. The application will take approximately 710
business days to process after application is received. If approved, you will receive a restriction notice (Form DC24L)
indicating, the length and detail of your restriction. The duration of the restriction time will be no greater than one year. If you
are able to resolve the circumstances that resulted in a failure to comply notice being sent to the Division, the restrictions
imposed, via an approved application, will be removed upon notice from the court. If approved, the restrictions shall be as
follows: To/from work or school, in the course of your employment, going to/from an appointment with a health care provider
or during a medical emergency, to/from drug or alcohol counseling and any place you are required to go by a court. If the
application is denied, the reason(s) for the denial will be stated.
Section 1, Applicant Information
Name as it appears on your driver’s license (please print):
Date of Birth:
Driver’s License Number:
Current Address (Note: if the address provided is different than the most recent address in the Division’s records, this
address will be considered a change of address, pursuant to K.S.A. 8248, and your driving record will be updated).
Street
City
State
Zip Code
Are you requesting the Division of Vehicles to determine if you are eligible for restricted driving privileges in lieu or your
suspension for failure to comply with a traffic citation?
Yes
No
Have you included a nonrefundable $25.00 application fee with this application?
Yes
No
Section 3. Acknowledgement
________________________________________________ _______________________________
Applicant’s Signature
Date
DC1020 (07/13)
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