Court Rules


Rule 62 - Drivers' Cases

Rule 62.3.1 - Form 451
IN THE CIRCUIT COURT OF JACKSON COUNTY, MISSOURI
AT KANSAS CITY AT INDEPENDENCE


APPLICANT,

vs. No. _______________

DIRECTOR OF REVENUE,
STATE OF MISSOURI,
RESPONDENT.
APPLICATION FOR HARDSHIP DRIVING PRIVILEGES

COMES NOW __________________________________________, Applicant, and in support of this Application for Hardship Driving Privileges, states:

1. That Applicant is a resident of Jackson County, Missouri, residing at _________________________________________________,
OR
That Applicant resides at _______________________________________,
County, Missouri, and maintains his/her principal place of business (or employment) at _______________________________, Jackson County, Missouri.
2. That until ____________________, 19 ____, Applicant was the holder of Missouri Driver's License No. _________________________. 3. That said license had no restrictions as to use of any kind. (Or that said license was restricted as to glasses, area, time, etc. Designate specific restriction.)
__________________________________________________________
4. That on _______________________________________, 19 ____, Applicant received notice from the Respondent that Applicant's driving privilege and aforesaid Driver's License were suspended (revoked) for a period of _________________________________ commencing __________ _____________, and ending _________________________ for the reason ____________________________________________ .





5. That Applicant is required to operate a motor vehicle in connection with (Applicant's business, occupation, or employment) (seeking medical treatment) (attending school or other institution of higher education) (attending alcohol or drug treatment programs) (other circumstances _________________________________), and that without the use of said automobile undue hardship will be worked on Applicant.
6. That Applicant's (place of employment), (school), (place of medical treatment, or alcohol or drug treatment program) is located at _______________________________________________ and the hours of Applicant's (employment), (school) (medical treatment for himself, or alcohol or drug treatment program) are _______________________ to __________________ Monday through Friday (or whatever is the fact).
7. That Applicant is not ineligible to receive hardship driving privileges for any of the reasons set out in the affidavit attached hereto as Exhibit "A" and incorporated into this Application by reference.
8. That attached hereto as Exhibit "B" is a duly certified copy of Applicant's complete driving record as maintained by the Missouri Department of Revenue; and attached as Exhibit "C" is proof of financial responsibility as required by Chapter 303, RSMo.
WHEREFORE, Applicant prays this Court for an Order granting hardship driving privileges (to and from Applicant's place of employment) (in the course of Applicant's employment) (to and from Applicant's place of employment and in the course of Applicant's employment) (to and from school) (to and from Applicant's place of medical treatment) (to and from an alcohol or drug treatment program) during and throughout the period of revocation stated above.


____________________ _____________________________________
DATE APPLICANT/ ATTORNEY FOR APPLICANT