Application for Ignition Interlock Assistance 
Use this form to make application for Ignition Interlock assistance for the first time. Approval for assistance of half the ignition interlock installation fee and monthly service fee(s) is based solely upon your enrollment and eligibility for the Federal Supplemental Nutrition Assistance Program (SNAP).

Verification of Ignition Interlock Assistance 
Use this form for continued Verification of Ignition Interlock Assistance. It must be filled out by the Ignition Interlock Installer upon each calibration. (For use only by Drivers already pre-approved for Ignition Interlock Assistance.)

Hearing or Record Review Request 
Use this form if you need to request a Contested Case Hearing OR a Record Review.