Notice Of Appeal (From DMV To Superior Court) {AP-102}

IN THE SUPERIOR COURT FOR THE STATE OF ALASKA AT _______________________ Appellant (person bringing appeal) vs. STATE OF ALASKA DEPARTMENT OF ADMINISTRATION DIVISION OF MOTOR VEHICLES, Appellee. ) ) ) ) ) ) ) ) ) ) ) APPEAL CASE NO. NOTICE OF APPEAL (from DMV to Superior Court) [AS 28.15.166(m)] CI Notice is hereby given that appeals to the Superior Court from the decision of the Division of Motor Vehicles Hearing Officer dated _________________________, 20______. A copy of the decision is attached. STATEMENT OF POINTS The reasons for this appeal are Date D.O.B. / A.D.L. No. Appellant's Signature Print Name Mailing Address City State ZIP Work Phone Home Phone I certify that on a copy of this notice and all other documents filed with it was mailed personally delivered to: __ DMV Director of Driver Licensing in Anchorage, and __ Attorney General of Alaska in Juneau By: AP-102 (1/12) (cs) NOTICE OF APPEAL (from DMV to Superior Court) App. R. 602 AS 28.15.166(m) American LegalNet, Inc. www.FormsWorkFlow.com