STATE OF WISCONSIN CIRCUIT COURT
STATE OF WISCONSIN CIRCUIT COURT SAUK COUNTY
[ ] STATE OF WISCONSIN
[ ] SAUK COUNTY
[ ] CITY/ VILLAGE OF ________________________
Plaintiff,
v. CASE NO: __________________
___________________________________________
___________________________________________, current address
___________________________________________
Defendant.
PETITION TO EXEMPT VEHICLES FROM IGNITION INTERLOCK REQUIREMENT
I, the above-named Defendant, petition the Court to exempt the following vehicle(s) from the Ignition Interlock Device requirement of § 343.301 of the Wisconsin Statutes.
I understand that I MUST have an ignition interlock device on any vehicle I operate. I will have or already have had an Ignition Interlock device installed on the following vehicles:
|Year |Make |Vehicle ID Number (VIN) |License Plate |
| | | | |
| | | | |
My reasoning for petitioning is as follows: _________________________________________
________________________________________________________________________________
________________________________________________________________________________
Attach Additional Pages if necessary
I have registered in my name, or my name appears on the title, to the following vehicles. (You may attach a list of these vehicles or a Department of Transportation printout of owned/registered/titled vehicles). This list must be complete or your request for an exemption may be denied. I am requesting to exempt the following vehicles:
|Year |Make |Vehicle ID Number (VIN) |License Plate |
| | | | |
| | | | |
| | | | |
| | | | |
| | | | |
| | | | |
Under Oath I state that the above information is true and correct.
___________________________________________
Signature and Date
................
................
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