12-Point Petition

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12-POINT PETITION
SAMPLE
Date______________
Bedford Municipal Court
165 Center Road
Bedford, OH 44146-2898
Gentlemen:
I am hereby petitioning this Court for a hearing to Retain my Driving
Privileges in accordance with Ohio Revised Code 4507.02.01. I reside within the
jurisdiction of the Bedford Municipal Court, agree to pay all costs incurred, and have
sufficient evidence to warrant the requested hearing.
I am notifying the Bureau of Motor Vehicles by certified mail of this petition by
sending them a copy of this letter and requesting a record of convictions.
Very truly yours,
________________________________
Sign your name
________________________________
Print your Street Address
________________________________
Print you City, State and Zip
________________________________
Print your Social Security Number
________________________________
Print your Driver’s License Number
________________________________
B.M.V. Number

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