nINSERT "fam-1 caption.

wpt"o

nASK General stuffo

PETITION FOR COURT ORDERED SUSPENSION OF nTYPE OF LICENSE 1o

Comes now the nClient's party designationo, in person and by counsel, and petitions this Court pursuant to nWhat
kind of license to suspendo of the nOpposing party's party designationo, nOpposing party's name:Like Thiso,
(hereinafter "Obligor"), and in support of said petition now states:

1. That the Obligor is under a continuing order to pay support for the minor child in the amount of $nPayor's weekly
current child support paymento per week through the Clerk of this court.

2. There is an arrearage on this case in an amount greater than two thousand dollars ($2000.00) or the equivalent of
three (3) months. See attached Exhibits A and B. (A support docket from the Clerk's office, and arrearage calculations,
respectively).

3. That the Obligor is delinquent in the payment of child support (as defined in I.C. 12-17-2-34) as an intentional
violation of an order of support.

4. nIF Driver's 3 oThat the Obligor currently holds an Indiana driver's license (Exhibit No. C).n ELSE IF
Professional 3o That the Obligor currently holds a professional license as an nWhat is the professional licenseo; such
license is regulated under I.C. 31-16-12-8 regarding suspension of a professional license(s).nELSE IF Both 3o3oThat
the Obligor currently holds an Indiana driver's license (Exhibit No. C) and currently holds a professional license as an
nWhat is the professional licenseo; such license is regulated under I.C. 31-16-12-8 regarding suspension of a
professional license(s).nEND IFo

5. That due to the Obligor's delinquency as an intentional violation of a support order, the Court should order the
suspension of the Obligor's driver's license.

WHEREFORE, the nClient's party designationo requests this Court set the matter for hearing on suspension of
Obligor's nIF prayer driver's license odriver's license nELSE IF prayer professionalonWhat is the professional
license onELSE IF prayer drivers and professionalodriver's license and nWhat is the professional licenseonEND IFo,
and for all other relief just and proper in the premises.

I affirm, under the penalties for perjury, that the foregoing representations are true.

___________________________________________
nClient's nameo, nClient's party designationo