![]() Select “S” if you would like to move within the same county.ħ. Select “C” if you would like to move to a new county. If you wish to register to vote or change political affiliation select “Yes”. Do you wish to register to vote or change political affiliation or voter address? Do you wish to register to vote or change political affiliation? If you had or experienced any of the medical conditions specified on the back of the form that affects your ability to operate a motor vehicle safely, select “yes” and briefly explain on the space provided. Within the last five years, have you had or experienced any of the medical conditions specified on the back of this form that affects your ability to operate a motor vehicle safely? If you had your driver's license canceled, refused, delayed, suspended, or revoked, select “Yes” then enter the date and reasoning on the space provided. Have you had your driving privilege or a driver license cancelled, refused, delayed, suspended, or revoked? If you have applied for a DL or ID Card in California or another state or country using a different name or number within the past ten (10) years, select “Yes” and print your name, DL/ID number, and state or country. Have you applied for a Driver License or Identification Card in California or another state/country using a different name or number within the past ten (10) years? The following question must be answered:Ī. If none from the basic and non-commercial license applies to you, select this box.ĥ. ![]() If you operate any single vehicle with a GVWR of 26,001 or more pounds or any such vehicle towing a vehicle, not above 10,000 pounds GVWR, select "Class B". If you operate any combination of vehicles with a gross combination weight rating (GCWR) of 26,001 or more pounds, provided the GVWR of the vehicle(s) being towed is more than 10,000 pounds, select "Class A". If you are operating a motor vehicle, select “Motorcycle”. If you are operating any single vehicle or combination of vehicles that is designated to transport 16 or more passengers including the driver, select “Basic Class C”. Provide your signature on the space provided. Complete this section only if you ARE NOT eligible for a social security number Box or Private Mail BoxĮnter your mailing address including Number, Street, Apartment or Space number, City, State, and Zip Code on the space provided.Įnter your residential address including Number, Street, Apartment or Space number, City, State, and Zip Code on the space provided.ģ. Select the type of card with which you would like to change your name(DL or ID Card).Įnter your Driver License or ID Card Number.Įnter the State or Country where your driver's license or ID card was issued.Įnter the expiration date of your license or card. If your identification card was stolen, check the box for stolen. If your identification card was lost, check the box for lost. ![]() Select what you would like to do for your Identification Card or ID (Original ID Card or Renewal, Senior ID Card, or Renewal (Age 62+). If your driver’s license was stolen, check the box for stolen. If your driver’s license was lost, check the box for lost. Select what you would like to do for your driver’s license (Original DL/Permit, Renewal, Duplicate, Remove restriction or Change/Adds Class).
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