Maine Chemical-Test Refusal Administrative Suspension Hearing Request
MAINE CHEMICAL-TEST REFUSAL ADMINISTRATIVE SUSPENSION HEARING REQUEST
Before sending: Use this request only if the Secretary of State's notice identifies an alleged failure to submit to and complete a chemical test under 29-A M.R.S. § 2521. Under § 2483(1), make the written request within 10 days from the suspension's effective date. A timely request for a refusal hearing does not itself stay the suspension. Read the notice for eligibility and delivery instructions, send the request promptly, and keep proof. A late request may qualify only for the narrow grounds in § 2483(3), without a stay on that ground.
Date: [__/__/____]
To: Bureau of Motor Vehicles, Division of Legal Affairs, Adjudications & Hearings
29 State House Station
Augusta, Maine 04333-0029
From: [FULL LEGAL NAME]
Date of birth: [__/__/____]
Driver license or history number: [________________________________]
Current mailing address: [________________________________]
Daytime telephone: [________________________________]
Email, if used for scheduling: [________________________________]
Administrative suspension notice or case number: [________________________________]
Effective date stated in the notice: [__/__/____]
Date and manner notice was received: [________________________________]
Written request
I request an administrative hearing under 29-A M.R.S. §§ 2521(8) and 2483 to review the Secretary of State's chemical-test-refusal suspension identified above. Please send hearing notices and the decision to my mailing address stated here. I understand this request alone does not authorize me to drive while the suspension is in effect.
I ask the hearing officer to address the issue or issues supported by the evidence, including:
- ☐ Whether there was probable cause to believe I operated a motor vehicle while under the influence of intoxicants.
- ☐ Whether I was told the consequences of failing to submit to and complete a test.
- ☐ Whether I failed to submit to and complete a test.
- ☐ If the notice invokes § 2521(6-A), whether the additional probable-cause condition concerning death was present.
- ☐ Whether I would have completed the test but for the officer's failure to give the warnings required by § 2521(3).
Facts supporting the checked issue or issues: [DESCRIBE THE INCIDENT AND IDENTIFY WHAT IS DISPUTED]
[____________________________________________________________]
[____________________________________________________________]
Records or witnesses I expect to present, if known: [________________________________]
Representative, if any: [NAME AND CONTACT INFORMATION / NONE]
Late-request explanation, only if applicable
☐ This request is after the ordinary 10-day period. I ask the Secretary of State to consider § 2483(3) because I was unable to make a timely request due to ☐ lack of actual notice ☐ physical incapacity. The relevant dates and supporting facts are: [________________________________]. Supporting records attached: [________________________________]. I understand a late hearing granted under this exception does not carry a stay.
Please confirm receipt and provide the hearing number and scheduling information.
Signature: [________________________________] Date signed: [__/__/____]
Printed name: [________________________________]
Attachment: ☐ copy of the suspension notice ☐ supporting records listed above
Delivery record — retain with your copy
The BMV Hearings Section asks for a written request with the identifying details above and a brief statement of the matter. Check the notice for case-specific instructions.
Method and destination used: [________________________________]
Date sent: [__/__/____] Date received, if confirmed: [__/__/____]
Delivery confirmation: [________________________________]
About this template
- Last updated
- November 2, 2026
- Citations checked
- November 2, 2026
- Jurisdiction
- Maine
- Category
- Criminal Law
Legal authority
- 29-A M.R.S. § 2521(3), (5), (7)-(8)
- 29-A M.R.S. § 2483(1), (3)-(4)
Criminal law paperwork covers every stage of a criminal case, from the first appearance and bail motion through pretrial motions, plea agreements, sentencing, and appeals. Deadlines in criminal cases are short and often unforgiving, and constitutional rights can be waived just by missing a filing. Using the right motion at the right time can mean the difference between evidence getting suppressed, charges getting reduced, or a case getting dismissed entirely.
Not legal advice
This template is provided for informational purposes. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.
Checked against the law it cites
A reviewer verified this template's legal citations against the official source on November 2, 2026.
29-A M.R.S. § 2521(5) (checked November 2, 2026): "The Secretary of State shall immediately suspend the license of a person who fails to submit to and complete a test."
29-A M.R.S. § 2521(8) (checked November 2, 2026): "If a hearing is requested in accordance with section 2483, in addition to specific issues required by a specific offense, the scope of the hearing must include whether:"
29-A M.R.S. § 2521(7) (checked November 2, 2026): "A suspension must be removed if, after hearing pursuant to section 2483, it is determined that the person would not have failed to submit but for the failure of the law enforcement officer to give the warnings required by subsection 3."
29-A M.R.S. § 2483(1) (checked November 2, 2026): "A person may make a written request for a hearing to review the determination of the Secretary of State. The request must be made within 10 days from the effective date of the suspension."
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