Illinois Form DAH H 67 BAIID Questionnaire Guide

What Is Form DAH H 67 — BAIID Questionnaire?

Form DAH H 67 is the official BAIID Questionnaire issued by the Illinois Secretary of State, Department of Administrative Hearings. It is a required document for many petitioners seeking restricted driving privileges that involve a Breath Alcohol Ignition Interlock Device.

A BAIID is a device installed in a vehicle’s ignition system. The driver must provide a breath sample before the vehicle will start. In Illinois, the device is calibrated so the vehicle will not start if the driver’s blood-alcohol concentration (BAC) registers .025 or higher. Illinois also requires a camera unit that photographs the person providing the breath sample.

The questionnaire gathers practical information about the vehicles you plan to drive, other household drivers, any prescription medications you take, and the specific type of restricted permit you are requesting. Completing it accurately helps the Secretary of State determine the appropriate driving restrictions and confirm that a BAIID can be properly monitored.

You can download the official fillable PDF directly from the Illinois Secretary of State website:

Download Form DAH H 67 — BAIID Questionnaire (Official PDF)

Who Needs to Complete the BAIID Questionnaire?

You generally need Form DAH H 67 if you are applying for a Restricted Driving Permit (RDP) and fall into one of the categories that require a BAIID. According to the Illinois Secretary of State, a BAIID is typically required when:

• You have two or more DUI convictions
• You have two statutory summary suspensions from separate DUI arrests
• You have one DUI conviction plus a statutory summary suspension from a different arrest
• You have an aggravated DUI conviction involving death, great bodily harm, or permanent disability
• You are seeking any driving relief after a lifetime revocation

First-time offenders who qualify for a Monitoring Device Driving Permit (MDDP) also use BAIID devices, though the specific paperwork requirements may differ slightly. The questionnaire is listed among the official Administrative Hearings forms and is commonly required as part of the formal hearing or permit application process.

For the most current requirements, review the official BAIID resources on the Illinois Secretary of State website: BAIID Department page and About BAIID.

What Information Does Form DAH H 67 Collect?

The form is relatively short but requires precise answers. Key sections include:

• Type of permit requested — Options include Employment, Medical, Support, Educational, Family Education, Day Care, BMO (Breath Alcohol Monitoring Only or related category), and Probationary.
• Vehicles for BAIID installation — List the make, model, and year of each vehicle in which you will install the device. Circle any vehicles you own.
• Other household drivers — Provide the number of other drivers in your household, along with their names, ages, and relationships to you.
• Prescription medications — List any prescription medications you currently take.
• Work-related questions (if applicable) — If requesting a work permit for a personal vehicle or a work vehicle, you must answer detailed questions about your occupation, whether you need to drive to/from work or on the job, whether work vehicles can be taken home, and any other employment details relevant to your driving needs.

At the end of the form, you must sign and date it under penalty of perjury pursuant to Section 1-109 of the Illinois Code of Civil Procedure, certifying that the statements are true and correct. You also provide your driver’s license number and contact telephone numbers.

The current version of the form (DAH H 67.8, printed April 2023) remains the standard document available from the Secretary of State.

How Form DAH H 67 Fits Into the Illinois BAIID Program?

Submitting the questionnaire is only one part of the process. Petitioners must also typically:

• Complete other required Administrative Hearings forms and documentation (alcohol evaluations, treatment verification, character references, etc.)
• Agree to the official BAIID Terms and Conditions (Form DAH H 66)
• Install a certified BAIID within the required timeframe (usually 14 days after a permit is issued)
• Return for monitoring and calibration at required intervals (initial report within 30 days, then every 60 days)
• Comply with all reporting and violation-response rules

Failure to install the device on time, maintain it properly, or respond to violation notices can result in cancellation of the restricted permit and other consequences. The Secretary of State’s BAIID Division monitors device data and may request explanations for any recorded violations.

Related official forms available from the same publications page include the BAIID Terms and Conditions (DAH H 66) and Supplemental Hearing Instructions for Alcohol- and DUI-Related Hearings (DAH H 65). You can find the full list of Administrative Hearings forms here: Administrative Hearings Publications and Forms.

How to Complete and Submit Form DAH H 67?

Follow these best practices:

1. Download the official PDF from the Illinois Secretary of State website (link provided above). Forms on the site are fillable PDFs.
2. Open the form in Adobe Acrobat Reader for the best results, as recommended by the Secretary of State.
3. Answer every required question completely and accurately. Incomplete forms can delay your hearing or permit decision.
4. Print the completed form, sign it by hand (if required), and include it with your other hearing or petition documents.
5. Submit according to the instructions provided with your hearing notice or formal petition package. Addresses for the Department of Administrative Hearings appear on the form itself (Springfield and Chicago locations).

Keep a copy of the completed form for your records. If you are working with an attorney experienced in Illinois driver’s license reinstatement matters, provide them with a copy as well.

Important Tips for Illinois Drivers

• Use only the official form from ilsos.gov. Third-party versions may be outdated or incomplete.
• Be truthful. The form is signed under penalty of perjury.
• If your employment situation is complex (multiple job sites, company vehicles, on-call duties), use the open-ended question at the end of the work section to provide additional relevant details.
• Coordinate vehicle information carefully. The Secretary of State needs to know exactly which vehicles will have the BAIID installed and monitored.
• Stay current with BAIID technology requirements. As of 2025, Illinois has implemented updated real-time reporting standards for devices.

Where to Get Help and Official Resources?

For questions about the BAIID program or Form DAH H 67, contact the Illinois Secretary of State BAIID Division:

• Springfield (serves most of Illinois outside Cook County): 217-524-0660
• Chicago (serves Cook County): 312-814-4598
• Email: [email protected]

Official resources:

• BAIID Department Home
• All About BAIID
• Administrative Hearings Forms List
• Direct Download — Form DAH H 67

Form DAH H 67 is a straightforward but important document in the process of regaining limited driving privileges in Illinois. Completing it carefully and submitting it with your other required materials helps the Department of Administrative Hearings evaluate your request efficiently and fairly.