Interlock Limited Driving Privilege Impaired Driving {CR-340}

File No. STATE OF NORTH CAROLINA In The General Court Of Justice County District Superior Court Division STATE VERSUS Name And Address Of Defendant INTERLOCK LIMITED DRIVING PRIVILEGE IMPAIRED DRIVING Race Sex Height Weight (N. C. CONVICTIONS ONLY) G.S. 20-179.3Hair Color Eye Color Date Of Birth Drivers License No. State Social Security No.Date Of Offense Date Of Conviction NOTE: Use AOC-CV-352 when defendants license was revoked for a conviction in another state or in a federal court. If a defendants license is revoked for a conviction of G.S. 20-138.1, and the defendant had an alcohol concentration of 0.16 or more, the Court must include the following in a limited driving privilege order: 1) a restriction that the applicant may operate only a designated motor vehicle; 2) a requirement that the designated motor vehicle be equipped with a functioning ignition interlock system of a type approved by the Commissioner of Motor Vehicles; and 3) a requirement that the applicant personally activate the ignition interlock system before driving the motor vehicle. FINDINGS Upon application of the defendant for a limited driving privilege, the Court finds that: 1. The defendant has been convicted of impaired driving under G.S. 20-138.1; G.S. 20-138.2; G.S. 20-138.3; 2. At the time of the offense, the applicant held either a valid drivers license or a license that had been expired for less than one (1) year; 3. At the time of the offense, the defendant had not within the preceding seven (7) years been convicted of an offense involving impaired driving; 4. Punishment level three, four, or five has been imposed upon the defendant for the offense of impaired driving, or the defendant has been convicted under G.S. 20-138.3; 5. Subsequent to the offense, the defendant has not been convicted of, or had an unresolved charge lodged against the defendant for, an offense involving impaired driving; 6. If applicable, the period of nonoperation has expired; 7. The records of the Division of Motor Vehicles and the Clerk of Superior Court in this county have been searched, and there are no other revocations in effect at this time; 8. The defendant has obtained and filed with the court a substance abuse assessment; 9. If convicted under G.S. 20-138.3, the defendant was 18, 19 or 20 years old on the date of the offense and has not previously been convicted of a violation of G.S. 20-138.3; 10. a. The Court has been furnished a properly executed form DL-123 and is satisfied that the defendant is financially responsible. b. The defendant has executed form DL-123A and is not required to furnish proof of financial responsibility. ORDER It is ORDERED that the defendant be allowed a limited driving privilege to be effective on the date indicated below to be used in accordance with the restrictions imposed on the reverse of this form, and to expire one year from the date on which the Division of Motor Vehicles revokes the defendants drivers license pursuant to G.S. 20-17(a)(2). This limited driving privilege is conditioned upon the maintenance of any financial responsibility required by G.S. 20-179.3(l) during the period of this privilege. Effective Date Date NOTE TO DEFENDANT: This privilege is no longer valid after Signature Of Judge the revocation period for the offense of which you were convicted has ended, or if your drivers license remains revoked Name Of Judge (Type Or Print) solely because the Division of Motor Vehicles has not obtained a certificate of your completion of a substance abuse treatment program or an alcohol and drug education traffic school. AOC-CR-340, Rev. 6/2000 Original - File Certified Copy - Applicant Copy - DMV 2000 Administrative Office of the Courts (Over) <<<<<<<<<********>>>>>>>>>>>>> 2 RESTRICTIONS The driver shall not drink alcohol while driving or drive while any alcohol remains in his/her body. The driver shall not drive while having a controlled substance in his/her body unless such controlled substance was lawfully obtained and taken in therapeutically approved amounts. This limited driving privilege DOES NOT include the privilege of operating a commercial motor vehicle as defined in G.S. 20-4.01(3d). Driving when essential for emergency medical care is authorized at any time. Standard working hours are from 6 AM to 8 PM, Monday - Friday. Driving, other than for emergency medical care is permitted only as follows: (check only applicable boxes.) 1. Driving is permitted for work-related or educational purposes during standard working hours as follows: 2. Driving is permitted for maintenance of household during standard working hours as follows: 3. Driving is permitted for work-related or education purposes during nonstandard working hours as follows: The driver is self employed and the required documentation for work-related driving is attached. 4. Driving is permitted for community service assignment, Alcohol and Drug Education Traffic School, and substance abuse assessment or treatment as follows: 5. Driving is restricted to: a. The following non-commercial vehicle(s): , which shall be equipped with a functioning interlock system of a type approved by the Commissioner of Motor Vehicles and the defendant shall personally activate the ignition interlock system before operating the vehicle and at any time during the driving as required by the procedures for ignition interlock systems established by the Commissioner of Motor Vehicles. b. The following non-commercial vehicle(s): , which is owned by the defendants employer and is operated by the defendant solely for work-related purposes, and the vehicle owner has filed a written statement with the court authorizing such work- related driving by the defendant. 6. Additional restrictions: Corrective Lenses 45 M.P.H. Only Daylight Only Other: Name And Address Of ADET School, Community Service Coordinator, Or Mental HealthName And Address Of Employer Or Drivers Place Of Work Treatment Facility To Which Driver Assigned NOTICE/ACKNOWLEDGMENT OF RECEIPT I have received a copy of this limited driving privilege which contains the restrictions on my driving privilege. I understand that if I drive with the odor of alcohol on my breath, I may be subject to arrest and loss of this limited driving privilege; I understand that this is my limited license to drive; that I must keep it in my possession during the period of revocation; that if my drivers license is revoked for any other reason, this limited driving privilege is invalid; that a vio