Hearing Request to Contest Court-Ordered Visitation Abuse Driving Privileges Suspension - Illinois

The Illinois Secretary of State has released this version of the "Hearing Request to Contest Court-Ordered Visitation Abuse Driving Privileges Suspension" 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
Secretary of State
HEARING REQUEST TO CONTEST
DEPARTMENT OF
COURT-ORDERED VISITATION ABUSE
ADMINISTRATIVE HEARINGS
DRIVING PRIVILEGES SUSPENSION
17 N. State, Ste. 1200
RM 212, Howlett Bldg.
Chicago, IL 60602
Springfield, IL 62756
www.cyberdriveillinois.com
Petitioner's Name (Please Print)
Driver's License Number
Street Address
Telephone Number
City/State/ZIP
Date
Petitioner’s Signature
YOU CANNOT CONTEST THE VISITATION TERMS OR WHETHER YOU HAVE VIOLATED THE COURT ORDER OF
VISITATION AND WERE FOUND TO HAVE ENGAGED IN VISITATION ABUSE AND ARE IN CONTEMPT OF THE
COURT AT THIS HEARING. Your suspension is the result of notification that you violated a court order of visitation.To contest
whether you violated the visitation order and are in contempt of the court, you must contact the court that entered the order.
NOTE: Any request for a Formal Hearing must by law 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, or by credit/debit card by completing the
appropriate form. CASH IS NOT ACCEPTED. If a request is received without the fee attached, it will be returned
and no hearing will be scheduled. This fee is NON-REFUNDABLE once a hearing is scheduled in accordance with
Section 2-118 of the Illinois Vehicle Code and 92 Illinois Administrative Code 1001.70.
Send this petition to the location where you prefer the hearing be held:
q
q
Chicago
Office of the Secretary of State
Joliet
Office of the Secretary of State
Dept. of Administrative Hearings
Dept. of Administrative Hearings
17 N. State St., Ste. 1200, 60602
54 N. Ottawa St., 60432
312-793-3722
815-740-7171
q
q
Springfield
Office of the Secretary of State
Mt. Vernon
Office of the Secretary of State
Dept. of Administrative Hearings
Dept. of Administrative Hearings
Rm. 212 Howlett Bldg., 62756
218 S. 12th St., 62864
217-782-7065
618-242-8986
q
q
Please indicate preference:
a.m.
p.m.
Printed by authority of the State of Illinois • June 2016 • 1 • DAH H-86.1
Print
Reset
Office of the
Secretary of State
HEARING REQUEST TO CONTEST
DEPARTMENT OF
COURT-ORDERED VISITATION ABUSE
ADMINISTRATIVE HEARINGS
DRIVING PRIVILEGES SUSPENSION
17 N. State, Ste. 1200
RM 212, Howlett Bldg.
Chicago, IL 60602
Springfield, IL 62756
www.cyberdriveillinois.com
Petitioner's Name (Please Print)
Driver's License Number
Street Address
Telephone Number
City/State/ZIP
Date
Petitioner’s Signature
YOU CANNOT CONTEST THE VISITATION TERMS OR WHETHER YOU HAVE VIOLATED THE COURT ORDER OF
VISITATION AND WERE FOUND TO HAVE ENGAGED IN VISITATION ABUSE AND ARE IN CONTEMPT OF THE
COURT AT THIS HEARING. Your suspension is the result of notification that you violated a court order of visitation.To contest
whether you violated the visitation order and are in contempt of the court, you must contact the court that entered the order.
NOTE: Any request for a Formal Hearing must by law 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, or by credit/debit card by completing the
appropriate form. CASH IS NOT ACCEPTED. If a request is received without the fee attached, it will be returned
and no hearing will be scheduled. This fee is NON-REFUNDABLE once a hearing is scheduled in accordance with
Section 2-118 of the Illinois Vehicle Code and 92 Illinois Administrative Code 1001.70.
Send this petition to the location where you prefer the hearing be held:
q
q
Chicago
Office of the Secretary of State
Joliet
Office of the Secretary of State
Dept. of Administrative Hearings
Dept. of Administrative Hearings
17 N. State St., Ste. 1200, 60602
54 N. Ottawa St., 60432
312-793-3722
815-740-7171
q
q
Springfield
Office of the Secretary of State
Mt. Vernon
Office of the Secretary of State
Dept. of Administrative Hearings
Dept. of Administrative Hearings
Rm. 212 Howlett Bldg., 62756
218 S. 12th St., 62864
217-782-7065
618-242-8986
q
q
Please indicate preference:
a.m.
p.m.
Printed by authority of the State of Illinois • June 2016 • 1 • DAH H-86.1
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
q
q
State.)
Credit
Debit
Petitioner’s Name
Driver’s License Number
Street Address
City, State, ZIP Code
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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