Transcription of DC DRIVER LICENSE or IDENTIFICATION CARD APPLICATION
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DC DRIVER LICENSE or IDENTIFICATION CARD APPLICATION
DC DRIVER LICENSE or IDENTIFICATION CARD APPLICATION Th e in formatio n you provide will be used to re gist er you to vote or update your regis tratio n unless you decline in Sectio n G. A. What do you need? Driv er LICENSE Id entif icatio n Card Motorcycle Endorsement B. Tell us about yourself Last Name Fir st Name Middle Name , etc. Address where you liv e (a mailing only address cannot be used) Apt/Unit # City & State ZIP Code Washin gton, DC Date of Bir th Socia l Security # Citiz en Gender / / Yes No Male Female Unspecif ie d Weig ht Heig ht Hair Colo r Eye Colo r Other names you have used on a Driv er Lic ense or ID Card. LBS FT IN Cell Phone Alt ernate Phone Te xt Notific ation Email ( ) ( ) Yes Standard rates apply C.
I fy es, t oan i mp lch M d /Ey r . 1 . A lzheim e r’s D ise a se Y e s N o 2 . In su lin D e p e n d ent D ia b e te s Y e s N o 3 . G la u c o m a , Ca ta ra c ts, o r Eye D ise a se s Y e s N o 4 . Se izu re o r Loss o f Co n sc io u snes s Y e s N o 5 .
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