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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF TRANSPORTATION
Bureau of Driver Licensing
Harrisburg, PA 17123
JULY 01, 1998
ANDREW A HAINES
308 MARKET ST
LEMOYNE PA
17043
981756114326135 001
06/24/1998
21923092
12/02/1967
Dear Motorist:
As a result of your violation of Section 1547 of the
Vehicle Code, CHEMICAL TEST REFUSAL on 06/06/1998, your
dri ving privi.lege is being SUSPENDED for a period of 1
YEAR(S).
In order to comply with this sanction yOU are required to
return any current driver's license, learner's permit and/or
temporary driver's license (camera card) in your possession
no later than the effective date listed. If YOU cannot
comply with the requirements stated above. YOU are required
to submit a DL16LC Form or a sworn affidavit stating that
you are aware of the sanction against your driving
privilege. Failure to comply with this notice shall result
in this Bureau referring this matter to the PennsYlvania
State Police for prosecution under SECTION 1571(a)(4) of the
Vehicle Code.
Although the law mandates that your driVing privilege is
under suspension even if yOU do not surrender Your license,
Credit wIll nut ueylll until all. current driver's licAnse
product(s), the DL16LC Form, or a letter acknowledging your
sanction is received in this Bureau.
WHEN THE DEPARTMENT RECEIVES YOUR LICENSE OR
ACKNOWLEDGEMENT, WE WILL SEND YOU A RECEIPT. IF YOU DO NOT
RECEIVE THIS RECEIPT WITHIN 15 DAYS CONTACT THE DEPARTMENT
IMMEDIATELY. OTHERWISE, YOU WILL NOT BE GIVEN CREDIT TOWARD
SERVING THIS SANCTION.
The effective date of suspension is 08/05/1998, 12:01 a.m.
********************************************************************
IWARNING: If yoU are convicted for driving while your license is I
I suspended. the penalties will be: not less than 90 days imprison-I
Iment and a 1,000 fine and an additional 1 year suspenSion. I
***************************************************************11***
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(ConWnuatlon of No.' 2)
Defendant's Name:
AndreJ A. P.ai..~
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POLICE
CRIMINAL COMPLAINT
CUI
Docket Number
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2. The acts committed by the accused were: DRIVING UNDER THE INFLUENCE OF ALCOHOL AND/OR CONTROLLED
h SUBSTANCE: That he/she did unlawfuily then and there ~ drive, G operate, 0 or was in actual physical control of lho
movement of any vehicle 1981 Oldsrobile
bearing Pennsylvania Reg, no. a:i,{-2~ 15
~ while under the influence of alcohol to a degree which rendered him/trGltlncapable of safe driving.
. 0 while under the infiuence of a controiled substance, as defined in the act of April 14, 1972 (P.L. 233, No. 64), known as
. o. --"----"THE-'CONTROLLED SUBSTANSE, DRUG, DEVICE 'AND COSMETIC ACT," loa degree which rendered him/her
. A incapable of safe driving.
~ 0 while under the combined influence of alcohol and controlled substance to a degree. which rendered hlmlhor Incapable of
~ safe driVing.
il= I!I while the amount of alcohol by weight in the blood of the defendant is 0.10% or greater; To wit .207 0/0.
. i I!l the amount of alcohol by weight in the blood of the defendant is 0.10% or greater at the time of the chemical test of the
- defel')dilnts breath. blood. or urine which sample was:
. ~ obtained within 3 hours after the person drove, operated, or was In actual physical control of lhe vehicle;
o the circumstances of the incident prevented collecting' the sample within 3 hours, however, was obtained within a
reasonable time after the person drove, operated, or was In actual physical control of the vehicle. .
. all of which were against the peace and dignity of the Commonwealth of Pennsylvania and contrary to the Act of Assembly, or In
. violation of
4523
1.
(c:)
of'"
Title 75
(SeclJon)
3731
(Secllon)
(Subsection) (PASlAtulll
(8)0l.(a)(4)~~ TWe 75
(Subs8Cllon) , (PA Statule)
(OOtffiii)
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3.
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. 3. I ask that a warrant of arrest or a summons be issued and that the defendant be required to answer the charges I have made.
(In order for a warrant of arrest to Issue, the attached aftidavll of probabie cause must be completed and sworn to b9fore the
Issuing'authority. . . . '::;:\.,~;'
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I verily that the facts set forth in this complaint are true and correct to the best of my knowledge Qr Informallon and belief. This
verification is made SUbject to the penalties of Section 4904 of the1::~m/.es':Code (18. PA. C.S. ~4904) r~~Wllm/l?J unsworn .
falsification to authlll'it~ 98 J / /. r 11 ,I' /',/ /.,' I ~\\\\\~~LTH 01' ~11111i.
,19_ If /,Y( (, li: ,"-...,. (I...' ~,,~~ ~I1ICT JU"~-I< ~
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JunQ 16 98 _::;; (j ", ~.....
AND NOW, on this date ~. ,19_ , I certify that the complaint h@ bel1n . lelEi
and verified. An aftidavit of probable cause m.~ be .comple~~.~~rder J9t'a warrant to Issue. ~ * ~. ,f * ~
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