The DS-1205S Supplemental Chemical Test Report is used in conjunction with the DS-1205 Administrative License Suspension and Chemical Test Report. The DS-1205S is used to notify the Department of Driver Services of the final breath test results for a driving under the influence (DUI) of alcohol arrest.
The form must be filled out by the arresting officer if: (1) the test results show a blood alcohol content (BAC) of .08 grams or greater for a driver over the age of 21, (2) the test results show a BAC of .02 grams or greater for a driver under the age of 21, or (3) the test results show a BAC of .04 grams or greater for a driver operating a commercial vehicle.
The first section of the form is where the arresting officer inputs the incident data. This includes the incident date and time as well as the county and road of occurrence. The officer must also indicate the DUI citation number, if the driver was operating a commercial vehicle, and if hazardous materials were present.
The second section is for the driver’s data. The officer must input the driver’s name, date of birth, address, license number, state of issue, license class, license restrictions, height, weight, and gender.
The third section is for the officer’s sworn report, his or her data, and the test data. The officer must list his or her full name, telephone number, badge number, precinct, and post assignment. There are also fields for the name of the officer’s law enforcement agency, the agency’s ORI number, and the agency’s address. The final box in this section is for the driver’s test results.
The officer must swear that he or she has reasonable grounds to believe the driver was in physical control of the vehicle while under the influence or was involved in an accident that resulted in serious injury or death to others.
The officer must also affirm that the driver submitted to the chemical test and the test results prove that the driver’s BAC was above the legal limits. The officer must then sign the bottom of the DS-1205S form and have it signed and sealed by a notary public.
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