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Indiana Code Title 9. Motor Vehicles § 9-30-6-16

Current as of January 02, 2024 | Updated by FindLaw Staff

Sec. 16. The bureau certificate must contain the following information and may be substantially in the following form:

BUREAU OF MOTOR VEHICLESCERTIFICATE

Date of Arrest

Time

Driver's License No.

License State

a.m.

/

/

p.m.

Name: (first)

(M.I.)

(last)

Date of Birth

/

/

CURRENT Address (street, city, state, zip)

Court Code

Cause Number

Sex

Weight

Height

Eyes

Hair

The above motorist

REFUSED alcohol test

BUREAU USE ONLY

FAILED alcohol test 0.%

Court Determination

It has been determined there was probable cause the defendant violated IC 9-30-5 this _______ day of _______, 20__ and that charges are pending herein.

_______ Court

_______ County

_________________________________________________

Judge's Signature
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Cite this article: FindLaw.com - Indiana Code Title 9. Motor Vehicles § 9-30-6-16 - last updated January 02, 2024 | https://codes.findlaw.com/in/title-9-motor-vehicles/in-code-sect-9-30-6-16/

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