THIS INFORMATION IS NECESSARY FOR US TO REQUEST YOUR ALR HEARING.

IT IS *VERY* IMPORTANT THAT YOU ANSWER THE BEST OF YOUR ABILITY OR YOUR ALR REQUEST MAY BE FORFEIT. FOR EXAMPLE, IT IS *VERY* IMPORTANT THAT WE KNOW WHETHER TO SEND A "REFUSAL" OR A "CONSENT/FAILURE" REQUEST.

The above is what I know about my arrest to the best of my ability. I understand that incorrect information may mean I forfeit my right to an ALR hearing and that my license will be suspended:

*This is *VERY* important. If the wrong request is made, then DPS acts like no request was made at all and you WILL lose the opportunity for a hearing. A "failure" is when you consent/voluntarily give breath or blood. A voluntary breath test IS NOT a roadside test. The only breath test that matters is one performed at the police station after you were placed under arrest. A "refusal" is when police get a warrant to do a blood draw.

JUST BECAUSE POLICE DID A BLOOD DRAW DOES NOT MEAN YOU "GAVE" BLOOD FOR PURPOSES OF AN ALR REQUEST.

Please make sure you bring ANY jail paperwork with you to the consultation, as police should have given you a form called a DIC-25 (temporary driver's license) if they confiscated your license. This form should tell you whether the officer marked refusal or consent/failure.