Form CR-742 Request for Verification of Eligibility for Limited Driver's License After Therapeutic Court - Alaska

Form CR-742 is a Alaska Superior Court form also known as the "Request For Verification Of Eligibility For Limited Driver's License After Therapeutic Court". The latest edition of the form was released in May 1, 2018 and is available for digital filing.

Download an up-to-date Form CR-742 in PDF-format down below or look it up on the Alaska Superior Court Forms website.

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IN THE SUPERIOR COURT FOR THE STATE OF ALASKA
AT
STATE OF ALASKA
)
Plaintiff,
)
vs.
)
)
CASE NO.
CR
)
Defendant.
)
REQUEST FOR VERIFICATION OF
DOB:
) ELIGIBILITY FOR LIMITED DRIVER’S LICENSE
AFTER THERAPEUTIC COURT
This procedure is only available if you have successfully completed Therapeutic
INSTRUCTIONS:
Court as part of a court-ordered treatment program under AS 28.35.028. This procedure is only
available if you have a past felony conviction for operating a vehicle under the influence of alcohol or a
controlled substance (AS 28.35.030). It is not available if your conviction was for refusing to submit to
a chemical test (AS 28.35.032).
The court will not grant you a limited driver’s license. The Division of Motor Vehicles
NOTE:
(DMV) may do that if you first prove to the court that you meet the eligibility requirements below. If
the court determines you meet the eligibility requirements, you must still provide the DMV with the
following: (1) a copy of the court’s verification of eligibility for a limited driver’s license; (2) proof of
insurance as required by AS 28.20.230 and 28.20.240; (3) proof of installation of the ignition interlock
device on every vehicle you operate; (4) an affidavit signed at the DMV agreeing to the use of the
ignition interlock device; and (5) any other additional requirements and fee payments.
REQUEST
I,
, had my license revoked for a felony conviction
under AS 28.35.030. I request a verification showing I may be eligible for a limited driver’s license
because I successfully completed Therapeutic Court as part of a court-ordered treatment program
under AS 28.35.028 on the following date:
.
Date
Defendant’s Signature
Defendant’s Mailing Address
City
State
ZIP
Daytime Phone
ORDER
Request granted. A certificate of successful completion of Therapeutic Court as part of a court-
ordered treatment program is attached.
Request denied.
Date
Judge
Type or Print Judge’s Name
I certify that on
a copy of this order was given or sent to:
Clerk:
CR-742 (5/18)(cs)
AS 28.15.201(g)
REQUEST FOR VERIFICATION OF ELIGIBILITY FOR LIMITED DRIVER’S LICENSE AFTER THERAPEUTIC COURT
IN THE SUPERIOR COURT FOR THE STATE OF ALASKA
AT
STATE OF ALASKA
)
Plaintiff,
)
vs.
)
)
CASE NO.
CR
)
Defendant.
)
REQUEST FOR VERIFICATION OF
DOB:
) ELIGIBILITY FOR LIMITED DRIVER’S LICENSE
AFTER THERAPEUTIC COURT
This procedure is only available if you have successfully completed Therapeutic
INSTRUCTIONS:
Court as part of a court-ordered treatment program under AS 28.35.028. This procedure is only
available if you have a past felony conviction for operating a vehicle under the influence of alcohol or a
controlled substance (AS 28.35.030). It is not available if your conviction was for refusing to submit to
a chemical test (AS 28.35.032).
The court will not grant you a limited driver’s license. The Division of Motor Vehicles
NOTE:
(DMV) may do that if you first prove to the court that you meet the eligibility requirements below. If
the court determines you meet the eligibility requirements, you must still provide the DMV with the
following: (1) a copy of the court’s verification of eligibility for a limited driver’s license; (2) proof of
insurance as required by AS 28.20.230 and 28.20.240; (3) proof of installation of the ignition interlock
device on every vehicle you operate; (4) an affidavit signed at the DMV agreeing to the use of the
ignition interlock device; and (5) any other additional requirements and fee payments.
REQUEST
I,
, had my license revoked for a felony conviction
under AS 28.35.030. I request a verification showing I may be eligible for a limited driver’s license
because I successfully completed Therapeutic Court as part of a court-ordered treatment program
under AS 28.35.028 on the following date:
.
Date
Defendant’s Signature
Defendant’s Mailing Address
City
State
ZIP
Daytime Phone
ORDER
Request granted. A certificate of successful completion of Therapeutic Court as part of a court-
ordered treatment program is attached.
Request denied.
Date
Judge
Type or Print Judge’s Name
I certify that on
a copy of this order was given or sent to:
Clerk:
CR-742 (5/18)(cs)
AS 28.15.201(g)
REQUEST FOR VERIFICATION OF ELIGIBILITY FOR LIMITED DRIVER’S LICENSE AFTER THERAPEUTIC COURT

Download Form CR-742 Request for Verification of Eligibility for Limited Driver's License After Therapeutic Court - Alaska

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