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Email: dwgenis@msn.com
Notify the DMV
Your address and telephone number here
Month, day, 2004
Department of Motor Vehicles
Licensing Operations Division
Driver Safety Branch
4050 S. Saviers Road
Oxnard, California 93033-6499, or appropriate address if outside SB, SLO, or Ventura Counties
Sent Via Fax to (805) 488-3219
Re: Your Name
Your License Number:
To whom it may concern:
I now request the setting of a telephonic APS hearing. This request is made within ten (10) days of my arrest date. Therefore, I requests that a Stay be placed on the suspension pending the hearing.
I was arrested on Month Day, 2004 by the (name of agency) Department and completed a breath, or blood test, or was accused of refusing to take a chemical test.
Please contact me at (your area code telephone number and extension) in order to schedule the hearing. Do not schedule a hearing without clearing the date with me.
Sincerely,
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