The Contact Information for the Various Offices Is at the Bottom of This Form

To request a DMV hearing, this form must be filled out and faxed to every DMV driver safety office in your county.

The contact information for the various offices is at the bottom of this form.

You only have ten (10) days from the date of arrest to make this request.

I would not wait until the 10th day.

Keep the fax confirmation proving that it was faxed in.

Name:

Address:______

______(City) ______(State)

______(Zip Code)

Phone Number______

Date of Birth:______

Driver's License Number (include the state of issuance if not California):______

Date of Arrest:______

Arresting Agency (E.g. L.A.P.D., C.H.P., Etc):______

Dear Driver Safety Office:

I was arrested for Driving Under the Influence on ______(Date). I hereby demand an in person DMV hearing in pursuant to California Vehicle Code section 13558, which requires that my hearing be held and before any suspension or revocation of my license. I also demand a stay of any suspension or revocation of my license or driving privileges before my in person hearing and a decision is reached. discovery as required by law from your office.

Signed,

Name:

Bakersfield

• Address
  5800 District Blvd., Ste. 100-B, 93313-2148
• General Information or to Make an Appointment
  Phone (661) 833-2103
  Fax (661) 833-2102

City of Commerce

• Address
  5801 E. Slauson Avenue, Suite 250, 90040-3050
• General Information or to Make an Appointment
  Phone (323) 724-4000
  Fax 3237249262

City of Orange

• Address790 The City Drive, Suite 420, 92868-4941
• General Information or to Make an Appointment
  Phone (714) 703-2511
  Fax (714) 703-2526

Covina

• Address
  1365 N. Grand Ave., Suite 101, 91724-4048
• General Information or to Make an Appointment
  Phone (626) 974-7137
  Fax (626) 974-7118

El Segundo

• Address
  390 N. Sepulveda Blvd, Suite 2075, 90245-4470
• General Information or to Make an Appointment
  Phone (310) 615-3500
  Fax 3106153581

Fresno

• Address
  2510 S. East Avenue, Suite 310, 93706-5112
• General Information or to Make an Appointment
  Phone (559) 445-6399
  Fax (559) 445-6379 or 445-6396

Oakland

• Address
  7677 Oakport St. Suite #220, 94621
• General Information or to Make an Appointment
  Phone (510) 563-8900
  Fax (510) 563-8950

Oxnard

• Address
  2051 North Solar Drive, Suite 100., 93036-2650
• General Information or to Make an Appointment
  Phone (805) 988-3050
  Fax (805) 988-1420

Redding

• Address
  2650 Churn Creek Road, Suite 200, 96002-1169
• General Information or to Make an Appointment
  Phone (530) 224-4755
  Fax (530) 224-4737

Sacramento

• Address
  4700 Broadway, 2nd Floor, 95820-1501
• General Information or to Make an Appointment
  Phone (916) 227-2970
  Fax (916) 227-2901

San Bernardino

• Address
  1845 Business Center Dr., Ste. 212, 92408-3447
• General Information or to Make an Appointment
  Phone (909) 383-7413

San Diego

• Address
  1455 Frazee Road, Suite 400, 92108-4378
• General Information or to Make an Appointment
  Phone (619) 220-5300
  Fax (619) 220-5418

San Francisco

• Address
  1377 Fell St., 2nd Floor, 94117-2296
• General Information or to Make an Appointment
  Phone (415) 557-1170
  Fax (415) 557-7375

San Jose

• Address
  90 Great Oaks Blvd, Suite 104, 95119
• General Information or to Make an Appointment
  Phone (408) 229-7100
  Fax (408) 229-7128 or 229-7129

Stockton

• Address
  710 N. American St., 95202-1823
• General Information or to Make an Appointment
  Phone (209) 948-7715
  Fax (209) 463-4858

Van Nuys

6150 Van Nuys Blvd., Suite 205, 91401-3333

Phone (818) 376-4217
Fax 8183764215