staging2.fightyourownticket.com
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34.174.213.64
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URL:
https://staging2.fightyourownticket.com/
Submission: On August 27 via automatic, source certstream-suspicious — Scanned from DE
Submission: On August 27 via automatic, source certstream-suspicious — Scanned from DE
Form analysis
5 forms found in the DOMPOST /#wpcf7-f138-o1
<form action="/#wpcf7-f138-o1" method="post" class="wpcf7-form init" aria-label="Contact form" novalidate="novalidate" data-status="init">
<div style="display: none;">
<input type="hidden" name="_wpcf7" value="138">
<input type="hidden" name="_wpcf7_version" value="5.9.3">
<input type="hidden" name="_wpcf7_locale" value="en_US">
<input type="hidden" name="_wpcf7_unit_tag" value="wpcf7-f138-o1">
<input type="hidden" name="_wpcf7_container_post" value="0">
<input type="hidden" name="_wpcf7_posted_data_hash" value="">
<input type="hidden" name="_wpcf7_recaptcha_response"
value="03AFcWeA4JH8IVCRRj7MRfhBL1wKUV-I-ZHSa94P6ajssuJHcledPB9gBVvvifev3KMJvmBmMQQ4OmiOYO2xalL2v_eBL9ct7jLt_zPr9yqj-VS71JFYwIGpm6-PTwgjGy4TaqVgh9UVfd2MMeTGY5ADr7qA93LpCtJn6RExsyC0w-STXPQbbSM-nVPnV_fPGrcJ7zvaDhrV4Ts2FW4mPJFTjDwfksvH_7Hu5RyoVW--NyosMYi9NbzqQyx3d3rDT1dtrI7gNdk-6ekooQiNpnvvZMq1V1TtBw1sEzQ29QduhGIb3K4onGJ692LOJKU_ZEJ1l3ij_FLwUr43hEy-84uTyhCLMaLnKgsIaQAMrnmEZsmwrtEDL23L0uCisj2FDzqDhq_iB9rBlOIEPQ6z2otabg9Xl-jjZ1y_5YfsqY7Zsla0Umpky4DeK9TmDr6zPzf87abUW6OmZewe8mFJY5ZEf4TPRzO1jW4n9u-T7PKcOBZojLj7EER1KBa8PqEtFOXOBZMt_3xKiHcVVbqbBVdGh51T2yrDJtL0J_qP4leQaUOD5GmzO0L14I9sU_J-HpAPFdfD-TG9gcD6R4oG-s02KCFgcEMIEr7wmmNf7jsHjHDdmO903Eo9jKNpnEibZbvfYlVTvRbgKl6RN-h70ZcJ1DG1U8mR6pghNH903-A023e5OEDuMhvqotejery8dsPWK82DOcakQ0FV_bPM08bLP8NiwYlpU8iFGCBkHz4DAur03u8_St28GUMI7Eld87O7RZ0mwMdvr-9X6p-4wh99hud9yl8K3KRnAD0HdSwReBG-WvRuKNckjOl_WqKsKYFicz_n1w7qODdbDtBJAhK33CVeMRfH7q3RsjdfBiMjcM5jM56E_ACqKGxoO40Z8ptwaGZoZiVOFwl8fn6hH2JmzTZs6rlWKT0sz7P76AlDfOZJdAfDag3r32Ka_f6dFEsBSdLTMjhd9YCkVr6q3sF5cZgWRyL-fsiptwfG5jSolg_BoI3t6J-PQTRi6p2quIUvt8DcHvselo5vVbKHJ6bFqYCtiO939oDQdWtFWJOnCGt7LV1_J6AZaz6TUXDP3NxAMcIjZKz9248mRo0pOlzoBx-2bnki58BWFGVOcYVu_2q-pBTYfuE5LwChDYlnpnRQPBlFmc478VdfTGEhT6ve5INtFl5RjS8PdSc6aG5d8AjYb2ZcW-XtjoLYqQyxYpQvFk6N2xAC-d052ER_qk4WgnihwzlPJcTQXR0sUkr6y7JN46S9yGd5DJM2YvXuoMuyeG77nWsRlpZ7qMlsSQPAb9wk6pfPqjEiMhGBuCtmJyKZ7G0ZPTvkdtYGHs9s-tC1Mm2egMptfgaZh52RFdUAGGIFdWSldpHqO9__wMQdJBtSCM_7vwpWRqWQDbKbLSNRkdAfeeoBJcDPrm8A5-N0SQyW_mNhQV0rRb7MMaWHZSOjQaimxgnl2GI6eVmnir5vt0-mRI1sQwXX12get9LxEdS9bRsw3oCwe7f4StA39vQRsZI7UkKAmd-xXQ4tGRmC_Du4qyggh9qUMYxqEI2E6hYc64tNvb6e6FynhpsKh5OLzqB14ss2F13-crR2cVbss37QDUlUY_cznObE5jKyXOy_ppLJu68VVANwXQ2o9W2CciZrpQIqGhCk4YFpy57DUhjA_h-3M4Ta7Xo2uN46wMt_AqnfFpT02oE6sjACB3ioLnwDYcWrpT3NqiF7iIh4kytoCFzvRt6rdS-nv3vOvmOBQ0J1Qw5eE83_WuRJrx_wypF4nfU-sj4TjPzGY6et_uFmpPJD3pUhVId3PqrjOhfvRhFNKM0JhkTxTBjyvDhaKhZVV9l1uNz-tOpgvJkCt1BAbkR6jT2DnP0NTHX9PXM7e_qTtF3qiUXzmBdhaQBK_Ermvtjuw">
</div>
<div class="email_field">
<p><span class="wpcf7-form-control-wrap" data-name="your-email"><input size="40" class="wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email" aria-required="true" aria-invalid="false"
placeholder="Enter Email Address" value="" type="email" name="your-email"></span>
</p>
</div>
<div class="btn_field">
<p><input class="wpcf7-form-control wpcf7-submit has-spinner" type="submit" value="Subscribe"><span class="wpcf7-spinner"></span>
</p>
</div>
<div class="wpcf7-response-output" aria-hidden="true"></div>
</form>
POST
<form method="post" class="user_details_form">
<div class="field_group hidden">
<label for="order_id">Order ID</label>
<input type="text" name="order_id" id="order_id">
</div>
<div class="field_group">
<label for="cause_number">Cause Number</label>
<input type="text" name="cause_number" id="cause_number" required="">
</div>
<div class="field_group">
<label for="f_name">First Name</label>
<input type="text" name="f_name" id="f_name" required="">
</div>
<div class="field_group">
<label for="l_name">Last Name</label>
<input type="text" name="l_name" id="l_name" required="">
</div>
<div class="field_group">
<label for="municipal">Justice of the Peace OR Municipal</label>
<input type="text" name="municipal" id="municipal" required="">
</div>
<div class="field_group">
<label for="city">City</label>
<input type="text" name="city" id="city" required="">
</div>
<div class="field_group">
<label for="county">County</label>
<input type="text" name="county" id="county" required="">
</div>
<div class="field_group">
<label for="offense">Offense</label>
<input type="text" name="offense" id="offense" required="">
</div>
<div class="field_group">
<label for="date_of_trial">Date of Trial</label>
<input type="date" name="date_of_trial" id="date_of_trial" required="">
</div>
<div class="field_group">
<label for="curr_mail_address">Current Mailing Address</label>
<input type="text" name="curr_mail_address" id="curr_mail_address" required="">
</div>
<div class="field_group">
<label for="curr_mail_city">Current Mailing City</label>
<input type="text" name="curr_mail_city" id="curr_mail_city" required="">
</div>
<div class="field_group">
<label for="curr_mail_state">Current Mailing State</label>
<input type="text" name="curr_mail_state" id="curr_mail_state" required="">
</div>
<div class="field_group">
<label for="curr_mail_zip">Current Mailing Zip</label>
<input type="text" name="curr_mail_zip" id="curr_mail_zip" required="">
</div>
<div class="field_group">
<label for="judge_for_trial">Judge OR Jury for Trial</label>
<input type="text" name="judge_for_trial" id="judge_for_trial" required="">
</div>
<div class="field_group">
<label for="judge_for_punishment">Judge OR Jury for Punishment</label>
<input type="text" name="judge_for_punishment" id="judge_for_punishment" required="">
</div>
<div class="field_group">
<label for="list_of_witnesses">List of Witnesses</label>
<input type="text" name="list_of_witnesses" id="list_of_witnesses">
</div>
<div class="field_group">
<label for="reason_for_continuance">Reason for Continuance</label>
<input type="text" name="reason_for_continuance" id="reason_for_continuance">
</div>
<div class="submit_field">
<input type="submit" name="submit" id="submit">
<div class="lds-dual-ring"></div>
</div>
</form>
POST
<form method="post" class="user_details_form">
<div class="field_group hidden">
<label for="order_id">Order ID</label>
<input type="text" name="order_id" id="order_id">
</div>
<div class="field_group">
<label for="f_name">First Name</label>
<input type="text" name="f_name" id="f_name" required="">
</div>
<div class="field_group">
<label for="l_name">Last Name</label>
<input type="text" name="l_name" id="l_name" required="">
</div>
<div class="field_group">
<label for="justice_of_peace">Justice of the Peace OR County</label>
<input type="text" name="justice_of_peace" id="justice_of_peace" required="">
</div>
<div class="field_group">
<label for="number">Number</label>
<input type="text" name="number" id="number" required="">
</div>
<div class="field_group">
<label for="county">County</label>
<input type="text" name="county" id="county" required="">
</div>
<div class="field_group">
<label for="offense">Offense</label>
<input type="text" name="offense" id="offense" required="">
</div>
<div class="field_group">
<label for="curr_mail_address">Current Mailing Address</label>
<input type="text" name="curr_mail_address" id="curr_mail_address" required="">
</div>
<div class="field_group">
<label for="curr_mail_city">Current Mailing City</label>
<input type="text" name="curr_mail_city" id="curr_mail_city" required="">
</div>
<div class="field_group">
<label for="curr_mail_state">Current Mailing State</label>
<input type="text" name="curr_mail_state" id="curr_mail_state" required="">
</div>
<div class="field_group">
<label for="curr_mail_zip">Current Mailing Zip</label>
<input type="text" name="curr_mail_zip" id="curr_mail_zip" required="">
</div>
<div class="field_group">
<label for="country">Country</label>
<input type="text" name="country" id="country" required="">
</div>
<div class="field_group">
<label for="phone_number">Phone Number</label>
<input type="tel" name="phone_number" id="phone_number" required="">
</div>
<div class="field_group">
<label for="email_address">Email Address</label>
<input type="email" name="email_address" id="email_address" required="">
</div>
<div class="field_group">
<label for="date_of_birth">Date of Birth</label>
<input type="date" name="date_of_birth" id="date_of_birth" required="">
</div>
<div class="field_group">
<label for="social_security_number">Last 4 Digits of social security number</label>
<input type="text" name="social_security_number" id="social_security_number" required="">
</div>
<div class="field_group">
<label for="driver_license_number">Driver's License Number</label>
<input type="text" name="driver_license_number" id="driver_license_number" required="">
</div>
<div class="field_group">
<label for="driver_license_number_state">Driver's License Number State</label>
<input type="text" name="driver_license_number_state" id="driver_license_number_state" required="">
</div>
<div class="field_group">
<label for="driver_license_expiration_date">Driver's License Expiration Date</label>
<input type="date" name="driver_license_expiration_date" id="driver_license_expiration_date" required="">
</div>
<div class="field_group">
<label for="dl_suspended_disability">Is your license suspended because of a physical or mental disability?</label>
<div class="sub_field_group">
<input type="radio" name="dl_suspended_disability" id="dl_suspended_disability_yes" value="yes" required="">
<label for="dl_suspended_disability_yes">Yes</label>
</div>
<div class="sub_field_group">
<input type="radio" name="dl_suspended_disability" id="dl_suspended_disability_no" value="no">
<label for="dl_suspended_disability_no">No</label>
</div>
</div>
<div class="field_group">
<label for="dl_suspended_non_payment">Is your license suspended for non-payment of child support?</label>
<div class="sub_field_group">
<input type="radio" name="dl_suspended_non_payment" id="dl_suspended_non_payment_yes" value="yes" required="">
<label for="dl_suspended_non_payment_yes">Yes</label>
</div>
<div class="sub_field_group">
<input type="radio" name="dl_suspended_non_payment" id="dl_suspended_non_payment_no" value="no">
<label for="dl_suspended_non_payment_no">No</label>
</div>
</div>
<div class="field_group">
<label for="odl_count">Have you had 2 or more occupational driver's licenses in the last 10 years because of convictions?</label>
<div class="sub_field_group">
<input type="radio" name="odl_count" id="odl_count_yes" value="yes" required="">
<label for="odl_count_yes">Yes</label>
</div>
<div class="sub_field_group">
<input type="radio" name="odl_count" id="odl_count_no" value="no">
<label for="odl_count_no">No</label>
</div>
</div>
<div class="field_group">
<label for="dl_suspended_521_342">Is your license suspended under Transportation Code section 521.342.</label>
<div class="sub_field_group">
<input type="radio" name="dl_suspended_521_342" id="dl_suspended_521_342_yes" value="yes" required="">
<label for="dl_suspended_521_342_yes">Yes</label>
</div>
<div class="sub_field_group">
<input type="radio" name="dl_suspended_521_342" id="dl_suspended_521_342_no" value="no">
<label for="dl_suspended_521_342_no">No</label>
</div>
</div>
<p class="fields_sec_title">Is your license suspended because you were you convicted of: </p>
<div class="field_group">
<label for="dl_suspended_criminally_negligent_homicide">Criminally Negligent Homicide? (Penal Code section 19.05)</label>
<div class="sub_field_group">
<input type="radio" name="dl_suspended_criminally_negligent_homicide" id="dl_suspended_criminally_negligent_homicide_yes" value="yes" required="">
<label for="dl_suspended_criminally_negligent_homicide_yes">Yes</label>
</div>
<div class="sub_field_group">
<input type="radio" name="dl_suspended_criminally_negligent_homicide" id="dl_suspended_criminally_negligent_homicide_no" value="no">
<label for="dl_suspended_criminally_negligent_homicide_no">No</label>
</div>
</div>
<div class="field_group">
<label for="driving_while_intoxicated">Driving While Intoxicated? (Penal Code section 49.04)</label>
<div class="sub_field_group">
<input type="radio" name="driving_while_intoxicated" id="driving_while_intoxicated_yes" value="yes" required="">
<label for="driving_while_intoxicated_yes">Yes</label>
</div>
<div class="sub_field_group">
<input type="radio" name="driving_while_intoxicated" id="driving_while_intoxicated_no" value="no">
<label for="driving_while_intoxicated_no">No</label>
</div>
</div>
<div class="field_group">
<label for="driving_intoxicated_with_child_passenger">Driving While Intoxicated with Child Passenger? (Penal Code section 49.045)</label>
<div class="sub_field_group">
<input type="radio" name="driving_intoxicated_with_child_passenger" id="driving_intoxicated_with_child_passenger_yes" value="yes" required="">
<label for="driving_intoxicated_with_child_passenger_yes">Yes</label>
</div>
<div class="sub_field_group">
<input type="radio" name="driving_intoxicated_with_child_passenger" id="driving_intoxicated_with_child_passenger_no" value="no">
<label for="driving_intoxicated_with_child_passenger_no">No</label>
</div>
</div>
<div class="field_group">
<label for="flying_while_intoxicated">Flying While Intoxicated? (Penal Code section 49.05)</label>
<div class="sub_field_group">
<input type="radio" name="flying_while_intoxicated" id="flying_while_intoxicated_yes" value="yes" required="">
<label for="flying_while_intoxicated_yes">Yes</label>
</div>
<div class="sub_field_group">
<input type="radio" name="flying_while_intoxicated" id="flying_while_intoxicated_no" value="no">
<label for="flying_while_intoxicated_no">No</label>
</div>
</div>
<div class="field_group">
<label for="boating_while_intoxicated">Boating While Intoxicated? (Penal Code 49.06)</label>
<div class="sub_field_group">
<input type="radio" name="boating_while_intoxicated" id="boating_while_intoxicated_yes" value="yes" required="">
<label for="boating_while_intoxicated_yes">Yes</label>
</div>
<div class="sub_field_group">
<input type="radio" name="boating_while_intoxicated" id="boating_while_intoxicated_no" value="no">
<label for="boating_while_intoxicated_no">No</label>
</div>
</div>
<div class="field_group">
<label for="amusement_ride_while_intoxicated">Assembling or Operating an Amusement Ride While Intoxicated? (Penal Code section 49.065)</label>
<div class="sub_field_group">
<input type="radio" name="amusement_ride_while_intoxicated" id="amusement_ride_while_intoxicated_yes" value="yes" required="">
<label for="amusement_ride_while_intoxicated_yes">Yes</label>
</div>
<div class="sub_field_group">
<input type="radio" name="amusement_ride_while_intoxicated" id="amusement_ride_while_intoxicated_no" value="no">
<label for="amusement_ride_while_intoxicated_no">No</label>
</div>
</div>
<div class="field_group">
<label for="intoxication_assault">Intoxication Assault? (Penal Code section 49.07)</label>
<div class="sub_field_group">
<input type="radio" name="intoxication_assault" id="intoxication_assault_yes" value="yes" required="">
<label for="intoxication_assault_yes">Yes</label>
</div>
<div class="sub_field_group">
<input type="radio" name="intoxication_assault" id="intoxication_assault_no" value="no">
<label for="intoxication_assault_no">No</label>
</div>
</div>
<div class="field_group">
<label for="intoxication_manslaughter">Intoxication Manslaughter? (Penal Code section 49.08)</label>
<div class="sub_field_group">
<input type="radio" name="intoxication_manslaughter" id="intoxication_manslaughter_yes" value="yes" required="">
<label for="intoxication_manslaughter_yes">Yes</label>
</div>
<div class="sub_field_group">
<input type="radio" name="intoxication_manslaughter" id="intoxication_manslaughter_no" value="no">
<label for="intoxication_manslaughter_no">No</label>
</div>
</div>
<p class="fields_sec_title">If yes to the preceding section:</p>
<div class="field_group">
<label for="date_of_conviction">Date of Conviction</label>
<input type="date" name="date_of_conviction" id="date_of_conviction">
</div>
<div class="field_group">
<label for="court_of_conviction">Court of Conviction</label>
<input type="text" name="court_of_conviction" id="court_of_conviction">
</div>
<div class="field_group">
<label for="county_of_conviction">County of Conviction</label>
<input type="text" name="county_of_conviction" id="county_of_conviction">
</div>
<p class="fields_sec_title">Please answer the following questions about why your driver license is suspended.</p>
<div class="field_group">
<label for="breath_sample_provided">Were you arrested and the breath sample provided registered above 0.08?</label>
<div class="sub_field_group">
<input type="radio" name="breath_sample_provided" id="breath_sample_provided_yes" value="yes" required="">
<label for="breath_sample_provided_yes">Yes</label>
</div>
<div class="sub_field_group">
<input type="radio" name="breath_sample_provided" id="breath_sample_provided_no" value="no">
<label for="breath_sample_provided_no">No</label>
</div>
</div>
<div class="field_group">
<label for="refused_to_give_breath_sample">Were you arrested and refused to give a breath sample, as requested?</label>
<div class="sub_field_group">
<input type="radio" name="refused_to_give_breath_sample" id="refused_to_give_breath_sample_yes" value="yes" required="">
<label for="refused_to_give_breath_sample_yes">Yes</label>
</div>
<div class="sub_field_group">
<input type="radio" name="refused_to_give_breath_sample" id="refused_to_give_breath_sample_no" value="no">
<label for="refused_to_give_breath_sample_no">No</label>
</div>
</div>
<p class="fields_sec_title">If Yes to the two preceding questions</p>
<div class="field_group">
<label for="date_of_arrest">Date of Arrest</label>
<input type="date" name="date_of_arrest" id="date_of_arrest">
</div>
<div class="field_group">
<label for="arrest_for_DWI">Within the past ten (10) years from the date of the arrest that led to your current Driver License suspension, have you had a suspension for refusal to give a breath/blood sample or for providing a sample with a blood
alcohol content greater than 0.08 following an arrest for a DWI?</label>
<div class="sub_field_group">
<input type="radio" name="arrest_for_DWI" id="arrest_for_DWI_yes" value="yes" required="">
<label for="arrest_for_DWI_yes">Yes</label>
</div>
<div class="sub_field_group">
<input type="radio" name="arrest_for_DWI" id="arrest_for_DWI_no" value="no">
<label for="arrest_for_DWI_no">No</label>
</div>
</div>
<p class="fields_sec_title">My Driver License is suspended because:</p>
<div class="field_group">
<label for="convicted_an_offense">I was convicted of an offense.</label>
<div class="sub_field_group">
<input type="radio" name="convicted_an_offense" id="convicted_an_offense_yes" value="yes">
<label for="convicted_an_offense_yes">Yes</label>
</div>
<div class="sub_field_group">
<input type="radio" name="convicted_an_offense" id="convicted_an_offense_no" value="no">
<label for="convicted_an_offense_no">No</label>
</div>
</div>
<div class="field_group">
<label for="habitual_violator_of_traffic_laws">A Texas court determined that I am a "habitual violator of traffic laws?"</label>
<div class="sub_field_group">
<input type="radio" name="habitual_violator_of_traffic_laws" id="habitual_violator_of_traffic_laws_yes" value="yes">
<label for="habitual_violator_of_traffic_laws_yes">Yes</label>
</div>
<div class="sub_field_group">
<input type="radio" name="habitual_violator_of_traffic_laws" id="habitual_violator_of_traffic_laws_no" value="no">
<label for="habitual_violator_of_traffic_laws_no">No</label>
</div>
</div>
<div class="field_group">
<label for="driver_education_program">A Texas court ordered me to attend a Driver Education Program and automatically suspended my license, permit and/or driving privilege for 365 days?</label>
<div class="sub_field_group">
<input type="radio" name="driver_education_program" id="driver_education_program_yes" value="yes">
<label for="driver_education_program_yes">Yes</label>
</div>
<div class="sub_field_group">
<input type="radio" name="driver_education_program" id="driver_education_program_no" value="no">
<label for="driver_education_program_no">No</label>
</div>
</div>
<div class="field_group">
<label for="any_criminal_charges">Do you have any criminal charges pending?</label>
<div class="sub_field_group">
<input type="radio" name="any_criminal_charges" id="any_criminal_charges_yes" value="yes">
<label for="any_criminal_charges_yes">Yes</label>
</div>
<div class="sub_field_group">
<input type="radio" name="any_criminal_charges" id="any_criminal_charges_no" value="no">
<label for="any_criminal_charges_no">No</label>
</div>
</div>
<div class="field_group">
<label for="class_c_charges">You do not need to consider traffic or Class C charges.</label>
<div class="sub_field_group">
<input type="radio" name="class_c_charges" id="class_c_charges_yes" value="yes">
<label for="class_c_charges_yes">Yes</label>
</div>
<div class="sub_field_group">
<input type="radio" name="class_c_charges" id="class_c_charges_no" value="no">
<label for="class_c_charges_no">No</label>
</div>
</div>
<p class="fields_sec_title">If yes, Please list the pending criminal charges below.</p>
<div class="field_group">
<label for="dl_start_end_date">Does the suspension of your Driver License have a start and end date?*</label>
<div class="sub_field_group">
<input type="radio" name="dl_start_end_date" id="dl_start_end_date_yes" value="yes">
<label for="dl_start_end_date_yes">Yes</label>
</div>
<div class="sub_field_group">
<input type="radio" name="dl_start_end_date" id="dl_start_end_date_no" value="no">
<label for="dl_start_end_date_no">No</label>
</div>
</div>
<p class="fields_sec_title">If yes:</p>
<div class="field_group">
<label for="dl_start_date">Start Date:</label>
<input type="date" name="dl_start_date" id="dl_start_date">
</div>
<div class="field_group">
<label for="dl_end_date">End Date:</label>
<input type="date" name="dl_end_date" id="dl_end_date">
</div>
<div class="field_group">
<label for="why_need_odl">Why do you need an Occupational Driver License? (Check all that apply.)</label>
<div class="sub_field_group">
<input type="checkbox" name="why_need_odl" id="need_odl_for_work" value="for work">
<label for="need_odl_for_work">I need to drive to and from work.</label>
</div>
<div class="sub_field_group">
<input type="checkbox" name="why_need_odl" id="need_odl_for_school" value="for school">
<label for="need_odl_for_school">I need to drive myself or my family member(s) to and from school.</label>
</div>
<div class="sub_field_group">
<input type="checkbox" name="why_need_odl" id="need_odl_for_other_reasons" value="other reasons">
<label for="need_odl_for_other_reasons">Other Reasons.</label>
</div>
</div>
<p class="fields_sec_title">Employer's Information:</p>
<div class="field_group">
<label for="employer_address">Employer’s Address:</label>
<input type="text" name="employer_address" id="employer_address">
</div>
<div class="field_group">
<label for="employer_telephone">Employer’s Telephone:</label>
<input type="tel" name="employer_telephone" id="employer_telephone">
</div>
<div class="field_group">
<label for="days_hours_you_work">Days and hours you work:</label>
<input type="text" name="days_hours_you_work" id="days_hours_you_work">
</div>
<div class="field_group">
<label for="job_title">Job title:</label>
<input type="text" name="job_title" id="job_title">
</div>
<div class="field_group">
<label for="self_employed_as">I am self-employed as:</label>
<input type="text" name="self_employed_as" id="self_employed_as">
</div>
<div class="field_group">
<label for="work_address">My work address is:</label>
<input type="text" name="work_address" id="work_address">
</div>
<p class="fields_sec_title">List the days and hours that you work:</p>
<p class="fields_sec_title">Monday:</p>
<div class="field_group">
<label for="monday_start">Start:</label>
<input type="time" name="monday_start" id="monday_start">
</div>
<div class="field_group">
<label for="monday_end">End:</label>
<input type="time" name="monday_end" id="monday_end">
</div>
<p class="fields_sec_title">Tuesday:</p>
<div class="field_group">
<label for="tuesday_start">Start:</label>
<input type="time" name="tuesday_start" id="tuesday_start">
</div>
<div class="field_group">
<label for="tuesday_end">End:</label>
<input type="time" name="tuesday_end" id="tuesday_end">
</div>
<p class="fields_sec_title">Wednesday:</p>
<div class="field_group">
<label for="wednesday_start">Start:</label>
<input type="time" name="wednesday_start" id="wednesday_start">
</div>
<div class="field_group">
<label for="wednesday_end">End:</label>
<input type="time" name="wednesday_end" id="wednesday_end">
</div>
<p class="fields_sec_title">Thursday:</p>
<div class="field_group">
<label for="thursday_start">Start:</label>
<input type="time" name="thursday_start" id="thursday_start">
</div>
<div class="field_group">
<label for="thursday_end">End:</label>
<input type="time" name="thursday_end" id="thursday_end">
</div>
<p class="fields_sec_title">Friday:</p>
<div class="field_group">
<label for="friday_start">Start:</label>
<input type="time" name="friday_start" id="friday_start">
</div>
<div class="field_group">
<label for="friday_end">End:</label>
<input type="time" name="friday_end" id="friday_end">
</div>
<p class="fields_sec_title">Saturday:</p>
<div class="field_group">
<label for="saturday_start">Start:</label>
<input type="time" name="saturday_start" id="saturday_start">
</div>
<div class="field_group">
<label for="saturday_end">End:</label>
<input type="time" name="saturday_end" id="saturday_end">
</div>
<p class="fields_sec_title">Sunday:</p>
<div class="field_group">
<label for="sunday_start">Start:</label>
<input type="time" name="sunday_start" id="sunday_start">
</div>
<div class="field_group">
<label for="sunday_end">End:</label>
<input type="time" name="sunday_end" id="sunday_end">
</div>
<p class="fields_sec_title">School Information</p>
<div class="field_group">
<label for="school_1_name">School #1 Name:</label>
<input type="text" name="school_1_name" id="school_1_name">
</div>
<div class="field_group">
<label for="school_1_telephone">Telephone:</label>
<input type="tel" name="school_1_telephone" id="school_1_telephone">
</div>
<div class="field_group">
<label for="school_1_address">Address:</label>
<input type="text" name="school_1_address" id="school_1_address">
</div>
<div class="field_group">
<label for="school_2_name">School #2 Name:</label>
<input type="text" name="school_2_name" id="school_2_name">
</div>
<div class="field_group">
<label for="school_2_telephone">Telephone:</label>
<input type="tel" name="school_2_telephone" id="school_2_telephone">
</div>
<div class="field_group">
<label for="school_2_address">Address:</label>
<input type="text" name="school_2_address" id="school_2_address">
</div>
<div class="field_group">
<label for="counties_you_drive_through">Counties you drive through:</label>
<input type="text" name="counties_you_drive_through" id="counties_you_drive_through">
</div>
<div class="submit_field">
<input type="submit" name="submit" id="submit">
<div class="lds-dual-ring"></div>
</div>
</form>
POST
<form method="post" class="user_details_form">
<div class="field_group hidden">
<label for="order_id">Order ID</label>
<input type="text" name="order_id" id="order_id">
</div>
<div class="field_group">
<label for="cause_number">Cause/Citation Number</label>
<input type="text" name="cause_number" id="cause_number" required="">
</div>
<div class="field_group">
<label for="f_name">First Name</label>
<input type="text" name="f_name" id="f_name" required="">
</div>
<div class="field_group">
<label for="l_name">Last Name</label>
<input type="text" name="l_name" id="l_name" required="">
</div>
<div class="field_group">
<label for="justice_of_peace">Justice of the Peace OR County</label>
<input type="text" name="justice_of_peace" id="justice_of_peace" required="">
</div>
<div class="field_group">
<label for="city">City</label>
<input type="text" name="city" id="city" required="">
</div>
<div class="field_group">
<label for="county">County</label>
<input type="text" name="county" id="county" required="">
</div>
<div class="field_group">
<label for="offense">Offense</label>
<input type="text" name="offense" id="offense" required="">
</div>
<div class="field_group">
<label for="curr_mail_address">Current Mailing Address</label>
<input type="text" name="curr_mail_address" id="curr_mail_address" required="">
</div>
<div class="field_group">
<label for="curr_mail_city">Current Mailing City</label>
<input type="text" name="curr_mail_city" id="curr_mail_city" required="">
</div>
<div class="field_group">
<label for="curr_mail_state">Current Mailing State</label>
<input type="text" name="curr_mail_state" id="curr_mail_state" required="">
</div>
<div class="field_group">
<label for="curr_mail_zip">Current Mailing Zip</label>
<input type="text" name="curr_mail_zip" id="curr_mail_zip" required="">
</div>
<div class="field_group">
<label for="phone_number">Phone Number</label>
<input type="tel" name="phone_number" id="phone_number" required="">
</div>
<div class="field_group">
<label for="email_address">Email Address</label>
<input type="email" name="email_address" id="email_address" required="">
</div>
<div class="field_group">
<label for="surety">Surety</label>
<input type="text" name="surety" id="surety" required="">
</div>
<div class="submit_field">
<input type="submit" name="submit" id="submit">
<div class="lds-dual-ring"></div>
</div>
</form>
POST
<form method="post" class="user_details_form">
<div class="field_group hidden">
<label for="order_id">Order ID</label>
<input type="text" name="order_id" id="order_id">
</div>
<div class="field_group">
<label for="cause_number">Cause Number</label>
<input type="text" name="cause_number" id="cause_number" required="">
</div>
<div class="field_group">
<label for="f_name">First Name</label>
<input type="text" name="f_name" id="f_name" required="">
</div>
<div class="field_group">
<label for="l_name">Last Name</label>
<input type="text" name="l_name" id="l_name" required="">
</div>
<div class="field_group">
<label for="city">City</label>
<input type="text" name="city" id="city" required="">
</div>
<div class="field_group">
<label for="curr_mail_address">Current Mailing Address</label>
<input type="text" name="curr_mail_address" id="curr_mail_address" required="">
</div>
<div class="field_group">
<label for="curr_mail_city">Current Mailing City</label>
<input type="text" name="curr_mail_city" id="curr_mail_city" required="">
</div>
<div class="field_group">
<label for="curr_mail_state">Current Mailing State</label>
<input type="text" name="curr_mail_state" id="curr_mail_state" required="">
</div>
<div class="field_group">
<label for="curr_mail_zip">Current Mailing Zip</label>
<input type="text" name="curr_mail_zip" id="curr_mail_zip" required="">
</div>
<div class="field_group">
<label for="phone_number">Phone Number</label>
<input type="tel" name="phone_number" id="phone_number" required="">
</div>
<div class="field_group">
<label for="email_address">Email Address</label>
<input type="email" name="email_address" id="email_address" required="">
</div>
<div class="field_group">
<label for="date_of_hearing">Date of Hearing</label>
<input type="date" name="date_of_hearing" id="date_of_hearing" required="">
</div>
<div class="field_group">
<label for="time_of_hearing">Time of Hearing</label>
<input type="time" name="time_of_hearing" id="time_of_hearing" required="">
</div>
<div class="field_group">
<label for="dl_or_id">Driver License OR ID #</label>
<input type="text" name="dl_or_id" id="dl_or_id" required="">
</div>
<div class="field_group">
<label for="dl_id_state">DL/ID State</label>
<input type="text" name="dl_id_state" id="dl_id_state" required="">
</div>
<div class="field_group">
<label for="date_of_birth">Date of Birth</label>
<input type="date" name="date_of_birth" id="date_of_birth" required="">
</div>
<div class="field_group">
<label for="officer_name">Officer Name</label>
<input type="text" name="officer_name" id="officer_name" required="">
</div>
<div class="field_group">
<label for="officer_agency">Officer Agency</label>
<input type="text" name="officer_agency" id="officer_agency" required="">
</div>
<div class="field_group">
<label for="date_of_arrest">Date of Arrest</label>
<input type="date" name="date_of_arrest" id="date_of_arrest" required="">
</div>
<div class="field_group">
<label for="county_of_arrest">County of Arrest</label>
<input type="text" name="county_of_arrest" id="county_of_arrest" required="">
</div>
<div class="submit_field">
<input type="submit" name="submit" id="submit">
<div class="lds-dual-ring"></div>
</div>
</form>
Text Content
Skip to content * info@fightyourownticket.com * Blog Facebook-f Instagram X-twitter * Home * About Us * Services * Court to Trial * Appeal Your Ticket * Administrative License Revocation (ALR) * Occupational Driver’s License Menu * Home * About Us * Services * Court to Trial * Appeal Your Ticket * Administrative License Revocation (ALR) * Occupational Driver’s License * Find a Lawyer * Contact Us * My Account Menu * Find a Lawyer * Contact Us * My Account Sign In * Home * About Us * Services * Court to Trial * Appeal Your Ticket * Administrative License Revocation (ALR) * Occupational Driver’s License * Find a Lawyer * Blog * Contact Us Menu * Home * About Us * Services * Court to Trial * Appeal Your Ticket * Administrative License Revocation (ALR) * Occupational Driver’s License * Find a Lawyer * Blog * Contact Us No products in the cart. $0.00 0 Cart * Home * About Us * Services * Court to Trial * Appeal Your Ticket * Administrative License Revocation (ALR) * Occupational Driver’s License * Find a Lawyer * Blog * Contact Us Menu * Home * About Us * Services * Court to Trial * Appeal Your Ticket * Administrative License Revocation (ALR) * Occupational Driver’s License * Find a Lawyer * Blog * Contact Us No products in the cart. $0.00 0 Cart TAKE CONTROL OF YOUR TRAFFIC TICKET FIGHT IT YOURSELF WITH FIGHTYOUROWNTICKET.COM Empower Yourself. Save Money. Win Your Case! Select Services ABOUT US Welcome to our website – Fight Your Own Ticket, your premier destination for handling traffic citations efficiently and affordably. We understand the impact a traffic ticket can have on your finances and driving record, which is why we’re dedicated to providing you with the means to fight back effectively. Our platform eliminates the need for expensive legal representation, putting the power directly in your hands. With our intuitive interface and comprehensive resources, you’ll gain the knowledge and tools necessary to challenge your ticket with confidence. From speeding violations to red light infractions, we’ve got you covered. At Fight Your Own Ticket, our mission is to empower individuals like you to take control of their circumstances and protect their driving privileges. Don’t let a simple citation disrupt your life – fight back with Fight Your Own Ticket. Learn More WHY SHOULD YOU HAVE TO PAY A HEFTY FINE FOR A TRAFFIC TICKET? Don’t let a simple ticket derail your finances and driving record. With FightYourOwnTicket.com, take control and fight your own traffic ticket, without the need for expensive lawyers. Our user-friendly platform empowers you with the knowledge and tools to challenge your ticket and win! WHY CHOOSE FIGHTYOUROWNTICKET.COM? COST-EFFECTIVE SOLUTIONS Save hundreds on legal fees by handling your own case. No need for expensive lawyers! No hidden charges or monthly subscriptions – just a one-time fee for access all the forms you’ll need to fight any tickets that come your way. STEP-BY-STEP GUIDANCE Gain access to easy-to-follow, jargon-free instructions to navigate the legal process. Links and FAQs are available for a hassle-free experience. TAILORED STRATEGIES Customized defense strategies for different types of traffic violations. Proven templates and samples for effective advocacy. SAVE TIME Skip the research – we've compiled all the necessary information in one easy to access place. Quick and efficient platform designed for busy individuals. CONFIDENCE BOOST Gain the confidence to present your case in court or through online platforms. PRICED ACCORDING TO YOUR NEEDS COURT TO TRIAL $50 Legal proceedings for traffic violations. * Defendant's Election On Punishment * Defendant's Motion For Daubert Hearing * Defendant’s Motion For Continuance * Defendant’s Motion For Production Pursuant To Rules 612 And 615 * Defendant’s Motion For Speedy Trial * Defendant’s Motion To Invoke The Rule * Defendant’s Motion To Require State To List Its Witnesses * Defendant’s Motion To Suppress * Defendant’s Motion To Suppress Custodial Statement * Defendant’s Motion To Suppress Statement - Miranda * Defendant’s Motion To Suppress Statement - Voluntariness * Defendant’s Plea And Request For Discovery And Brady Material * Defendant’s Request For Notice Of Extraneous Crimes Or Acts * Defendant’s Request For State’s Designation Of Experts * Defendant’s Subpoena Application * Defendant’s Subpoena Duces Tecum Application * Order On Defendant's Motion For Daubert Hearing * Order On Defendant’s Motion For Speedy Trial * Order On Defendant’s Motion To Invoke The Rule * Order On Defendant’s Motion To Require State To List Its Witnesses * Order On Defendant’s Motion To Suppress * Order On Defendant’s Motion To Suppress Custodial Statement * Order On Defendant’s Motion To Suppress Statement - Miranda * Order On Defendant’s Motion To Suppress Statement - Voluntariness * Order On Defendant’s Request For Discovery And Brady Material * Order On Defendant’s Request For Notice Of Extraneous Crimes Or Acts * Order On Defendant’s Request For State’s Designation Of Experts * Order On Motion For Continuance * Order On Motion For Production Pursuant To Rules 612 And 615 * Order On Motion To Disclose Experts * Subpoena * Subpoena Duces Tecum Show More Read More APPEAL YOUR TICKET $50 Challenging a traffic ticket in court. * Affidavit Inability To Afford Appeal Bond * Appeal Bond Cash * Appeal Bond Surety * Appeal Transcript Request * Motion For New Trial * Notice Of Appeal * Order For New Trial Show More Read More ADMINISTRATIVE LICENSE REVOCATION (ALR) $50 License suspension due to DUI or other offenses. * Order Motion to Continue * Respondent's ALR Hearing Appeal And Transcript Request * Respondent's ALR Hearing Request * Respondent's Discovery Request * Respondent's Five Day Continuance Request * Respondent's Motion to Continue * Respondent's Motion to Set Aside Default * Respondent's Request for Decision on Written Submission * Respondent's Subpoena Request Show More Read More OCCUPATIONAL DRIVER'S LICENSE $100 Specialized license for individuals with DUI convictions. * Affidavit Inability To Pay Court Costs * Agreed Order Setting Hearing * Odl Order-essential Need * Odl Order-interlock Device * Odl Petition-essential Need * Odl Petition-interlock Device Show More Read More HOW FIGHTYOUROWNTICKET.COM WORKS Sign Up Create your account in minutes with a simple sign-up process. Case Assessment Choose from our options to meet your specific needs. Document Preparation Access templates and guidelines to prepare a strong defense. Confidence in Court Walk into court with confidence, armed with the knowledge to present your case effectively. Why Wait? Start Fighting Today! READY TO TAKE CONTROL? Don’t let a traffic ticket dictate your financial future. Empower yourself with FightYourOwnTicket.com and fight your own battles. Get Started Now WHAT OUR CUSTOMERS ARE SAYING Hear directly from our satisfied clients about their experiences with our challan services. Gain valuable insights into our efficient solutions and helpful support. See why our customers trust us for their traffic-related needs. GAVIN WALTON "Absolutely fantastic service! FightYourOwnTicket.com equipped me with everything I needed to build a strong defense in traffic court. Their expertise helped me navigate the legal process smoothly, resulting in a win!" WILLIAM WHITE "Kudos to FightYourOwnTicket.com for empowering individuals like me to take control of their traffic violations. Their comprehensive forms helped me achieve a positive outcome in court. Highly recommended!" BRUNO TALLEY "FightYourOwnTicket.com exceeded my expectations! With their forms, I was able to challenge my traffic ticket confidently. The result? Victory! I couldn't have done it without their support and expertise." MICHAEL EVANS "A game-changer for anyone facing a traffic violation! FightYourOwnTicket.com provides invaluable resources and support to help you represent yourself effectively in court. I successfully contested my ticket with their help!" JAMES HUNT "If you're considering fighting your own ticket, look no further than FightYourOwnTicket.com. Their user-friendly platform and comprehensive forms make navigating traffic court a breeze. A definite win-win!" MARK SMITH "FightYourOwnTicket.com is a lifesaver! I was hesitant to represent myself in traffic court, but this website guided me through the process flawlessly. I won my case and saved hundreds in legal fees. Highly recommend!" HENRY ROBERTS "Incredible resource! FightYourOwnTicket.com provided me with all the tools and knowledge I needed to confidently defend myself in traffic court. Thanks to their guidance, I got my ticket dismissed!" TOM WALKER "I can't thank FightYourOwnTicket.com enough for their assistance. The step-by-step instructions were easy to follow, and their tips were invaluable. Successfully fought my ticket and couldn't be happier!" SOPHIA ROGERS "Don't underestimate the power of representing yourself in traffic court with FightYourOwnTicket.com by your side. They empowered me with knowledge and strategies that led to a favorable outcome. Truly grateful!" EMMA MORRIS "Five stars for FightYourOwnTicket.com! Their user-friendly platform gave me the confidence to take on my traffic violation case. The outcome? Ticket dismissed! Saved money and gained peace of mind!" GAVIN WALTON "Absolutely fantastic service! FightYourOwnTicket.com equipped me with everything I needed to build a strong defense in traffic court. Their expertise helped me navigate the legal process smoothly, resulting in a win!" WILLIAM WHITE "Kudos to FightYourOwnTicket.com for empowering individuals like me to take control of their traffic violations. Their comprehensive forms helped me achieve a positive outcome in court. Highly recommended!" BRUNO TALLEY "FightYourOwnTicket.com exceeded my expectations! With their forms, I was able to challenge my traffic ticket confidently. The result? Victory! I couldn't have done it without their support and expertise." MICHAEL EVANS "A game-changer for anyone facing a traffic violation! FightYourOwnTicket.com provides invaluable resources and support to help you represent yourself effectively in court. I successfully contested my ticket with their help!" JAMES HUNT "If you're considering fighting your own ticket, look no further than FightYourOwnTicket.com. Their user-friendly platform and comprehensive forms make navigating traffic court a breeze. A definite win-win!" MARK SMITH "FightYourOwnTicket.com is a lifesaver! I was hesitant to represent myself in traffic court, but this website guided me through the process flawlessly. I won my case and saved hundreds in legal fees. Highly recommend!" HENRY ROBERTS "Incredible resource! FightYourOwnTicket.com provided me with all the tools and knowledge I needed to confidently defend myself in traffic court. Thanks to their guidance, I got my ticket dismissed!" TOM WALKER "I can't thank FightYourOwnTicket.com enough for their assistance. The step-by-step instructions were easy to follow, and their tips were invaluable. Successfully fought my ticket and couldn't be happier!" SOPHIA ROGERS "Don't underestimate the power of representing yourself in traffic court with FightYourOwnTicket.com by your side. They empowered me with knowledge and strategies that led to a favorable outcome. Truly grateful!" EMMA MORRIS "Five stars for FightYourOwnTicket.com! Their user-friendly platform gave me the confidence to take on my traffic violation case. The outcome? Ticket dismissed! Saved money and gained peace of mind!" ‹› FREQUENTLY ASKED QUESTIONS Find answers to common queries about traffic violations, legal procedures, and licenses. Get clarity on contesting violations, appealing tickets, administrative processes, and obtaining occupational driving privileges. Q: I received a traffic citation. What are my options? You can either plea “Guilty,” “No Contest,” or “Not Guilty,” If you want to plea “guilty” or “no contest” you will waive your right to a trial by jury. You should do this on or before the appearance date shown on the citation. You will pay the fine and court costs for your ticket, and it will be on your driving record along with other possible consequences. If you choose “Not Guilty” then you will get the chance to fight your ticket. Again, you can plea “Not Guilty” on or before the appearance date shown on the citation. Q: Do I have to appear in Persson in Court? Yes, you must appear in court unless you decide to plea “Guilty” or “No Contest” and pay the fine and court costs before your court date. If you choose to fight your ticket and plea “Not Guilty,” then you must make an appearance in court. It is best to be prepared for your first court appearance. Our forms and guides will help you get the best outcome for your case. Q: What if I Missed my Court Date? If you missed your court date, thenan arrest warrant has been issued. If you come into contact with a police officer, they will be obligated to arrest you on the warrant. You should act quickly to avoid this problem. You will have two options: Post Bond at the Court: You may post bail at the court. The bond may be paid as a Cash Bond or as a Surety Bond. For a cash bond, you must pay cash to the court in the amount of the bond. Then you will be given a new court date.You can also post a Surety Bond. A bonding company can post the bond for you as your surety. Pay the Fine for the Ticket: You can pay the fine and court costs listed on the ticket. If you pay the fine, no further court appearance is necessary. However, this is an admission of guilt, and the ticket will appear on your driving record as a conviction. Missing court can have other consequences such as stopping you from renewing your driver’s license or a new criminal charge filed against you called a “Failure to Appear.” “Failure to Appear” is also a Class C Misdemeanor which you will also have to answer for. Q: Will a conviction for a traffic ticketappear on my driving record? Yes. Courts are required to submit convictions or forfeiture of bonds to the Texas Department of Public Safety. Q: Do I need an Attorney? No, in Texas you have a right to represent yourself in a criminal case. Our forms and guides help empower people across Texas to stand up for themselves when facing traffic tickets. Q: What Happens If My Driver's License Gets Suspended, But I Drive Anyway? If you drive while your driver’s license is suspended or invalid, you can be charged with “Driving While License Invalid.” You can obtain an occupational driver’s license that will allow you to drive during your suspension for work or school or in some circumstances to drive 24 hours a day 7 days a week. FightYourOwnTicket.com makes it easy to file and submit your application for an occupational driver’s license so you can get back to living your life. SUBSCRIBE FOR THE LATEST UPDATES Fight Your Own Ticket empowers you to challenge traffic citations affordably. 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No products in the cart. $0.00 0 Cart + Order ID Cause Number First Name Last Name Justice of the Peace OR Municipal City County Offense Date of Trial Current Mailing Address Current Mailing City Current Mailing State Current Mailing Zip Judge OR Jury for Trial Judge OR Jury for Punishment List of Witnesses Reason for Continuance + Order ID First Name Last Name Justice of the Peace OR County Number County Offense Current Mailing Address Current Mailing City Current Mailing State Current Mailing Zip Country Phone Number Email Address Date of Birth Last 4 Digits of social security number Driver's License Number Driver's License Number State Driver's License Expiration Date Is your license suspended because of a physical or mental disability? Yes No Is your license suspended for non-payment of child support? Yes No Have you had 2 or more occupational driver's licenses in the last 10 years because of convictions? Yes No Is your license suspended under Transportation Code section 521.342. Yes No Is your license suspended because you were you convicted of: Criminally Negligent Homicide? (Penal Code section 19.05) Yes No Driving While Intoxicated? (Penal Code section 49.04) Yes No Driving While Intoxicated with Child Passenger? (Penal Code section 49.045) Yes No Flying While Intoxicated? (Penal Code section 49.05) Yes No Boating While Intoxicated? (Penal Code 49.06) Yes No Assembling or Operating an Amusement Ride While Intoxicated? (Penal Code section 49.065) Yes No Intoxication Assault? (Penal Code section 49.07) Yes No Intoxication Manslaughter? (Penal Code section 49.08) Yes No If yes to the preceding section: Date of Conviction Court of Conviction County of Conviction Please answer the following questions about why your driver license is suspended. Were you arrested and the breath sample provided registered above 0.08? Yes No Were you arrested and refused to give a breath sample, as requested? Yes No If Yes to the two preceding questions Date of Arrest Within the past ten (10) years from the date of the arrest that led to your current Driver License suspension, have you had a suspension for refusal to give a breath/blood sample or for providing a sample with a blood alcohol content greater than 0.08 following an arrest for a DWI? Yes No My Driver License is suspended because: I was convicted of an offense. Yes No A Texas court determined that I am a "habitual violator of traffic laws?" Yes No A Texas court ordered me to attend a Driver Education Program and automatically suspended my license, permit and/or driving privilege for 365 days? Yes No Do you have any criminal charges pending? Yes No You do not need to consider traffic or Class C charges. Yes No If yes, Please list the pending criminal charges below. Does the suspension of your Driver License have a start and end date?* Yes No If yes: Start Date: End Date: Why do you need an Occupational Driver License? (Check all that apply.) I need to drive to and from work. I need to drive myself or my family member(s) to and from school. Other Reasons. Employer's Information: Employer’s Address: Employer’s Telephone: Days and hours you work: Job title: I am self-employed as: My work address is: List the days and hours that you work: Monday: Start: End: Tuesday: Start: End: Wednesday: Start: End: Thursday: Start: End: Friday: Start: End: Saturday: Start: End: Sunday: Start: End: School Information School #1 Name: Telephone: Address: School #2 Name: Telephone: Address: Counties you drive through: + Order ID Cause/Citation Number First Name Last Name Justice of the Peace OR County City County Offense Current Mailing Address Current Mailing City Current Mailing State Current Mailing Zip Phone Number Email Address Surety + Order ID Cause Number First Name Last Name City Current Mailing Address Current Mailing City Current Mailing State Current Mailing Zip Phone Number Email Address Date of Hearing Time of Hearing Driver License OR ID # DL/ID State Date of Birth Officer Name Officer Agency Date of Arrest County of Arrest +