Alabama Law Enforcement Agency
Driver License Hearing Request

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DO NOT COMPLETE FOR MANDATORY LIABILITY INSURANCE (MLI).
Please visit Mandatory Liability Insurance
Date of request: 12/12/2018
Applicant Information
Regarding Alabama Driver License #:
First Name: Middle Name: Last Name:
Address:
City: State: Zip Code:
AL ID (if applicable): SSN:
Phone: Email:
Attorney Information (Optional)
Check here to indicate that all correspondence should go to Attorney's address instead of Applicant's.
Attorney Name:
Address:
City: State: Zip Code:
Phone: Email:
Hearing Request Letter

Dear Hearing Officer,

This is to advise you that the Applicant whose information is entered above seeks or requests a Hearing of type:

Comments:
The checkbox above must be checked in order to submit a request.



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