Free Occupational License Cover Sheet.PDF - Texas

121903 Filing Information Sheet

CAUSE NO. ________________
THE STATE OF TEXAS § § VS . § ________________________________________, § DEFENDANT § IN THE COUNTY CRIMINAL COURT AT LAW NO .______ OF HARRIS COUNTY, TEXAS

OCCUPATIONAL LICENSE CASE INFORMATION SHEET
You must complete this form and a file copy with every original petition. You must also attach a copy of this form to every original petition served. This information does not constitute a discovery request, response, or supplementation, and is not admissible at trial. On the date of the offense, Petitioner was under 21 years of age . On the date of the offense, Petitioner was over 21 years of age. Administrative License Suspension for : failing the breath or blood test refusing to give a specimen of breath or blood. Automatic Suspension after conviction or being placed on community supervision for: Criminally Negligent Homicide Fraudulent Government Records -- Prosecuted Under TEX. Drug Offense PENAL CODE § 37.10 DWI (Alcohol) False/Fictitious Driver's License DWI (Drug) or DPS I.D. Card Driving While Commercial Criminal Mischief / Graffiti License Disqualified Intoxication Assault With A DWLI Motor Vehicle Evading Arrest Intoxication Manslaughter Failure To Stop And Render Aid Racing False/Fictitious Motor Vehicle Other ___________________ License Plate, Registration ___________________________ Insignia, Or Safety Inspection Certificates The case was heard in County Crim. Court at Law No. ___. The case was heard in _____District Court The offense occurred in __________________ County. The license was suspended on ___________________.

Name of individual filing cover sheet:
Attorney or pro se (signature) Bar card (if applicable) Address Printed name Telephone number

121903 Filing Information Sheet

Statutory References for Automatic Suspensions Automatic Suspensions Criminally Negligent Homicide [TEX. TRANSP. CODE § 521.341] Drug Offense [TEX. TRANSP. CODE § 521.372] DWI (Alcohol) [TEX. TRANSP. C ODE § 521.344] DWI (Drug) [TEX. TRANSP. CODE § 521.372] Driving While Commercial License Disqualified [TEX. TRANSP. CODE §§ 522.071; 521.457; 521.292(a)(1); 521.293] DWLI [TEX. TRANSP. CODE §§ 521.457; 521.292; 521.293] Evading Arrest [TEX. TRANSP. CODE §§ 521.341(2)] Failure To Stop And Render Aid [TEX. TRANSP. C ODE §§ 521.341(6)] False/Fictitious Motor Vehicle License Plate, Registration Insignia, Or Safety Inspection Certificates [TEX. TRANSP. CODE § 521.3465] Fraudulent Government Records -- Prosecuted Under TEX. P ENAL CODE § 37.10 [TEX. TRANSP. C ODE §§ 521.3466, 521.312] False/Fictitious Driver's License or DPS I.D. Card [TEX. TRANSP. CODE §§ 521.341(7), 521.451] Criminal Mischief / Graffiti [TEX. TRANSP. CODE § 521.320] Intoxication Assault With A Motor Vehicle [TEX. TRANSP. C ODE § 521.341] Intoxication Manslaughter [TEX. TRANSP. CODE § 521.341] Racing [TEX. TRANSP. CODE § 521.350]