S) Name And Address Of Applicant Race Sex Height Hair Color Eye Color Weight Date Of Birth G.S. 20-179.3 Drivers License No. And State Date Of Offense Social Security No. Date Of Conviction NOTE: THIS IS A CIVIL ACTION. Use this form when the applicant's license is revoked because of a conviction in another jurisdiction substantially equivalent to impaired driving under G.S. 20-138.1. FINDINGS Upon application of the applicant for a limited driving privilege, the Court finds that:.
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How to fill out the Dl 123 Form Blank online
Filling out the Dl 123 Form Blank online is an important step in obtaining a limited driving privilege after an impaired driving conviction. This guide offers comprehensive, step-by-step instructions to support you in completing the form accurately.
Follow the steps to fill out the Dl 123 Form Blank online.
- Click the ‘Get Form’ button to acquire the form and access it in your preferred online editor.
- Begin by entering the applicant's name and address in the designated fields. Ensure that this information is accurate and up-to-date.
- Next, fill in the race, sex, height, hair color, eye color, and weight of the applicant. This information helps the authorities identify the individual.
- Provide the date of birth of the applicant. This is crucial for proving identity and eligibility.
- Enter the driver's license number and state of issuance, along with the date of offense and social security number. These details are vital for the review process.
- Indicate the date of conviction. Make sure this is the correct date related to the impaired driving charge.
- Review the findings section carefully and check the applicable box regarding proof of financial responsibility. Choose either option a or b based on the applicant's situation.
- Complete the order section by entering the effective date and signing where indicated. The chief district court judge will also need to print their name and sign.
- In the restricted driving privilege section, fill out any applicable restrictions and permits. Check the appropriate boxes according to the applicant's needs.
- Ensure the applicant acknowledges receipt of the limitations by signing and dating the acknowledgment section.
- Finally, certify the form by having the deputy clerk sign and date as necessary. Review the entire document for any missing information.
- Save changes, download, print, or share the completed form according to your needs.
Start filling out your documents online today to expedite your application process.
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