Vermont DUI Civil Suspension Hearing Request Preparation Worksheet (Form 240)
VERMONT DUI CIVIL SUSPENSION HEARING REQUEST PREPARATION WORKSHEET (FORM 240)
Before you use this: If you received a Vermont DUI civil-license-suspension notice and want to contest it, the Vermont Judiciary directs you to complete the Request for Hearing Regarding Intention to Suspend on the second page of the notice. Send that official request to the Department of Motor Vehicles within seven days after receiving the notice. The DMV then files it with the court. This worksheet is for preparation only; sending it to DMV or the court is not a hearing request.
The hearing request concerns the civil suspension. A criminal DUI charge is a separate companion case. Read the notice you received for its request-due date, suspension effective date, and preliminary-hearing information; those details can differ with the circumstances shown on the notice.
1. Notice and timing
Your name and contact details as shown on the notice: [________________________________]
Date and method you received the officer's notice: [________________________________]
Incident date and location: [________________________________]
Notice or incident number: [________________________________]
Request-due date printed on your notice: [__/__/____]
Suspension or disqualification effective date printed on your notice: [__/__/____]
2. Hearing request preparation
What does the notice say is the basis for the civil suspension? ☐ Alleged test refusal ☐ Reported test result ☐ Commercial-driver issue ☐ Other [________________________________]
Do you intend to request a hearing on the official form? ☐ Yes ☐ Still deciding
Court location, preliminary-hearing date, and time printed on your notice: [________________________________]
Records to keep with the notice: ☐ officer's notice ☐ test or refusal paperwork ☐ temporary-license or permit paperwork ☐ other [________________________________]
3. Complete and send the official request
☐ Use the second page of the Form 240 notice actually delivered to you. Sign its request-for-hearing section and follow its current DMV delivery instructions. The court's civil cases guide explains the seven-day period and that the DMV forwards a timely request to the court.
☐ Keep a copy of the signed request and proof of when and how DMV received or was sent it. Check the notice for the preliminary hearing's time and place, and attend or promptly address any need to change the setting with the court.
☐ Prepare for the preliminary hearing using the directions on the official notice. The notice addresses exchange of the records and witness information expected at that hearing.
Date and method official request sent or delivered to DMV: [________________________________]
Delivery confirmation or receipt: [________________________________]
Official sources
About this template
- Last updated
- October 27, 2026
- Last reviewed
- October 27, 2026
- Jurisdiction
- Vermont
- Category
- Criminal Law
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 October 27, 2026.
Vermont Judiciary, Criminal Division Civil Cases — DUI civil suspension (checked October 27, 2026): "You must file that request with the DMV within 7 days from the date you received that notice. The DMV then files this request with the court."
Vermont Judiciary, Notice of Intention to Suspend and Request for Hearing, Form 240 (checked October 27, 2026): "In order to request a hearing, sign the section of this form and mail or deliver the form to the Commissioner of Motor Vehicles at 120 State Street, Montpelier, VT 05603."
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