Hearing Request to Contest Delinquent Child Support Payment Suspension - Court Order - Illinois

The Illinois Secretary of State has released this version of the "Hearing Request to Contest Delinquent Child Support Payment Suspension - Court Order" on June 1, 2016.

This form may be used by all Illinois residents: download the printable PDF by clicking the link below and use it according to the applicable legal guidelines.

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Office of the
HEARING REQUEST TO CONTEST
Secretary of State
DELINQUENT CHILD SUPPORT
DEPARTMENT OF
ADMINISTRATIVE HEARINGS
PAYMENT SUSPENSION — COURT ORDER
www.cyberdriveillinois.com
Petitioner’s Name
Driver’s License Number
Street Address
City, State, ZIP
Telephone Number
(
)
I hereby request a hearing pursuant to Section 7-706 of the Illinois Vehicle Code (625 ILCS 5/7-706) to petition the Secretary of
State to remove the above suspension from my driving record for the following reasons (check appropriate boxes):
q
I am not the person who owes a duty to make payments under the Court Order of Support.
q
The authenticated document of a Court Order of Support does not indicate:
q
I am 90 days or more delinquent, or that I have been adjudicated in arrears in an amount equal to 90 days of
obligation or more.
q
I am in contempt of court for failure to pay child support.
q
A superseding authenticated document of any Court Order of Support has been entered.
For any boxes checked, please provide the facts to support the statement on the reverse side of this form and attach
a copy of the court order or authenticated document from the court (attach additional pages if needed).
Under penalties provided by law pursuant to §1-109 of the Illinois Code of Civil Procedure, the undersigned certifies the
statements set forth in this petition are true and correct.
__________________________________________________________
Petitioner’s Signature
Date
NOTE: You cannot contest the amount of your child support debt at this hearing. Your suspension is the result of a
court order. To contest the amount of the debt or that you owe a debt, you must contact the court that entered the
order.
FILING FEE: Any request for a formal hearing must be accompanied by a $50 filing fee in the form of a check or money
order, or by credit/debit card by completing the appropriate form, payable to Secretary of State. CASH IS NOT ACCEPTED. If
a request is received without the fee, the request will be returned and no hearing will be scheduled. The fee is non-refundable
once the hearing is scheduled, in accordance with Section 2-118 of the Illinois Vehicle Code and 92 Illinois Administrative Code
§1007.70.
Send this petition to the location you prefer the hearing be held:
q
q
Chicago:
Office of the Secretary of State
Joliet:
Office of the Secretary of State
Department of Administrative Hearings
Department of Administrative Hearings
17 N. State St., Ste. 1200
54 N. Ottawa St.
Chicago, IL 60602
Joliet, IL 60432
312-793-3722
815-740-7171
q
q
Springfield: Office of the Secretary of State
Mt. Vernon: Office of the Secretary of State
Department of Administrative Hearings
Department of Administrative Hearings
501 S. Second St.
218 S. 12th St.
Rm. 212 Howlett Bldg.
Mt. Vernon, IL 62864
Springfield, IL 62756
618-242-8986
217-782-7065
q
q
Please indicate preference:
a.m.
p.m.
Printed by authority of the State of Illinois. June 2016 — 1 — DAH H 79.2
Print
Reset
Office of the
HEARING REQUEST TO CONTEST
Secretary of State
DELINQUENT CHILD SUPPORT
DEPARTMENT OF
ADMINISTRATIVE HEARINGS
PAYMENT SUSPENSION — COURT ORDER
www.cyberdriveillinois.com
Petitioner’s Name
Driver’s License Number
Street Address
City, State, ZIP
Telephone Number
(
)
I hereby request a hearing pursuant to Section 7-706 of the Illinois Vehicle Code (625 ILCS 5/7-706) to petition the Secretary of
State to remove the above suspension from my driving record for the following reasons (check appropriate boxes):
q
I am not the person who owes a duty to make payments under the Court Order of Support.
q
The authenticated document of a Court Order of Support does not indicate:
q
I am 90 days or more delinquent, or that I have been adjudicated in arrears in an amount equal to 90 days of
obligation or more.
q
I am in contempt of court for failure to pay child support.
q
A superseding authenticated document of any Court Order of Support has been entered.
For any boxes checked, please provide the facts to support the statement on the reverse side of this form and attach
a copy of the court order or authenticated document from the court (attach additional pages if needed).
Under penalties provided by law pursuant to §1-109 of the Illinois Code of Civil Procedure, the undersigned certifies the
statements set forth in this petition are true and correct.
__________________________________________________________
Petitioner’s Signature
Date
NOTE: You cannot contest the amount of your child support debt at this hearing. Your suspension is the result of a
court order. To contest the amount of the debt or that you owe a debt, you must contact the court that entered the
order.
FILING FEE: Any request for a formal hearing must be accompanied by a $50 filing fee in the form of a check or money
order, or by credit/debit card by completing the appropriate form, payable to Secretary of State. CASH IS NOT ACCEPTED. If
a request is received without the fee, the request will be returned and no hearing will be scheduled. The fee is non-refundable
once the hearing is scheduled, in accordance with Section 2-118 of the Illinois Vehicle Code and 92 Illinois Administrative Code
§1007.70.
Send this petition to the location you prefer the hearing be held:
q
q
Chicago:
Office of the Secretary of State
Joliet:
Office of the Secretary of State
Department of Administrative Hearings
Department of Administrative Hearings
17 N. State St., Ste. 1200
54 N. Ottawa St.
Chicago, IL 60602
Joliet, IL 60432
312-793-3722
815-740-7171
q
q
Springfield: Office of the Secretary of State
Mt. Vernon: Office of the Secretary of State
Department of Administrative Hearings
Department of Administrative Hearings
501 S. Second St.
218 S. 12th St.
Rm. 212 Howlett Bldg.
Mt. Vernon, IL 62864
Springfield, IL 62756
618-242-8986
217-782-7065
q
q
Please indicate preference:
a.m.
p.m.
Printed by authority of the State of Illinois. June 2016 — 1 — DAH H 79.2
HEARING FILING FEE
By law, any request for a Hearing must be accompanied by a $50 filing fee. The fee may be submitted in the form
of a check or money order payable to Secretary of State. Payment also may be made by credit/debit card by
completing the form below. CASH IS NOT ACCEPTED. If a Hearing request is received without the filing fee, the form
will be returned and a hearing will not be scheduled. This fee is non-refundable in accordance with Section 2-118
of the Illinois Vehicle Code and 92 Illinois Administrative Code 1001.70.
To use a Visa, Novus/Discover, American Express or MasterCard as a method of payment for the Hearing filing fee,
please complete the information below. If paying by check, money order or attorney’s check, do not com -
plete this form.
The credit/debit card must have a valid expiration date and a good credit standing. A service fee of $1.18 is added
to the total for credit/debit charges. (This fee is charged by the bank. NO portion is retained by the Secretary of
State.)
q
q
Credit
Debit
Petitioner’s Name
Driver’s License Number
City, State, ZIP Code
Street Address
Daytime Telephone Number
Please check the appropriate card
(
)
q
q
q
q
Cardholder’s Name (as it appears on card)
SM
Cardholder’s Credit/Debit Card Number
Expiration Date
Cardholder’s Mailing Address
City
State
ZIP
I hereby authorize the Office of the Secretary of State to charge my credit/debit card account for payment to be
rendered plus the service fee.
___________________________________________________________________________________________________________
__________________________________________________
Date
Cardholder’s Signature
___________________________________________________________________________________________________________
__________________________________________________
Date
Petitioner’s Signature

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