THE STATE OF TEXAS (Defendant's Name)

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IN THE COUNTY CRIMINAL COURT NO. _____ OF DALLAS COUNTY, TEXAS

TO THE HONORABLE JUDGE OF SAID COURT:

   On this the ________ day of _____________, 2002, came on to be considered Motion to Suppress: Breath Test, and said Motion is hereby [GRANTED] [DENIED].

____________________________________ JUDGE PRESIDING