{"data":{"id":"us-in/ic-9-30-6-16","jurisdiction":"us-in","citation":"IC 9-30-6-16","heading":"Bureau certificate; form and contents","body":"Sec. 16. The bureau certificate must contain the following information and may be substantially in the following form:\nBUREAU OF MOTOR VEHICLES\nCERTIFICATE\nDate of Arrest | Time | Driver's License No. | License State\n | a.m. |  |\n | / / | p.m. |  |\nName: (first) | (M.I.) | (last) | Date of Birth\n |  |  | / /\nCURRENT Address (street, city, state, zip)\nCourt Code | Cause Number | Sex | Weight | Height | Eyes | Hair\nThe above motorist | BUREAU USE ONLY\n | REFUSED alcohol test\n | FAILED alcohol test 0.%\n | Court Determination\nIt has been determined there was probable cause the defendant violated IC 9-30-5 this ___________ day of ________________, 20__ and that charges are pending herein.\n_____________________ Court | ______________________ County\n | ____________________________\n | Judge's Signature","path":["TITLE 9. MOTOR VEHICLES","ARTICLE 30. GENERAL PENALTY PROVISIONS","Chapter 6. Implied Consent; Administrative and Evidentiary Matters"],"source_url":"https://iga.in.gov/ic/2026/Title_9.html#9-30-6-16","current_through":"2026","vintage":"2026","retrieved_at":"2026-07-08T17:54:09Z","sha256":"fe5781784bf93afd5664a51e1254ee229c40529d94051d3c581a09a866b0e395","source_id":"us-in","stale":false,"prev":"us-in/ic-9-30-6-15","next":"us-in/ic-9-30-6-17"},"notice":"GroundRules: Original legal text. Not legal advice."}