Get Kentucky Hardship License Application 2020-2024

Courts. ky. gov Citation No. EA L TH OF KE COMM O Doc. Code AAHD NT AOC-492 Rev. 5-16 Page 1 of 2 OF JUS TI Application for Hardship Driver s License Court COMMONWEALTH OF KENTUCKY PLAINTIFF VS. DEFENDANT Address Comes the Defendant and provides the following information in support of a request for a hardship license 1. NW UCKY KRS 189A. 400 - 189A. 460 601 KAR 12. 020 and 12. 060 lex et justitia RT Case No* C U E CO Commonwealth of Kentucky Court of Justice www. On 2 I plead guilty to OR was found guilty of violating KRS 189A. 010. I was convicted as a n Offender 18 - 21 years old w/alcohol concentration of. 02-. 08 license suspension period is 30 - 120 days Under 18 Offender license suspension period is longer of 30 - 120 days or until 18th birthday First-time Offender license suspension period is 30 - 120 days. 2. Due to this conviction my Kentucky operators license is suspended for days OR months. Said offense was committed 2. Judgment was imposed 2. 3. The minimum license suspension period expired 2. 4. There was a judicial finding of refusal to take an alcohol concentration or substance test. Yes No KRS 189A. 410 3 prohibits issuance of a hardship license to an individual who has refused a test. 5. Suspension of my driver s license hinders my ability to Check all that apply Continue my employment. Continue attending school or an educational institution* Obtain necessary medical care. Attend court-ordered counseling or other programs. Attend driver improvement alcohol or substance abuse education programs. 6. At the hearing I will provide to the Court proof of motor vehicle insurance and notarized documents as stated on page 2 of this form depending on whether the hardship license is sought for employment educational medical alcohol substance abuse education or treatment court-ordered counseling or other programs. WHEREFORE Defendant prays this Application for Hardship Driver s License will be granted for the remainder of the suspension period. CLERK S USE ONLY Hearing Date 2. Time a*m* p*m* Defendant s Signature Defendant s Attorney if any Date 2. Print Reset Form INSTRUCTIONS TO DEFENDANT FOR COMPLETING APPLICATION When filling in your NAME as the DEFENDANT on page one of this form also include your ADDRESS* 1. You must provide the following type of NOTARIZED document s depending on the reason you are requesting a license. Form AOC-492. A Affidavit for Hardship Driver s License may be used for this purpose. If the license is sought for employment purposes A written sworn statement from your employer detailing your job hours of employment and the necessity for you to use a motor vehicle either in work at the direction of your employer during work hours or in travel to and from work. If you are self-employed provide the described information together with a sworn and notarized statement attesting to the truth of the above information* A. institution that you attend containing your class schedule courses being taken and necessity for you to use a motor vehicle in travel to and from school or other educational institution* A license for educational purposes shall not include participation in sports social extracurricular fraternal or other noneducational activities.