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DRIVER'S LICENSE AND IDENTIFICATION CARD …

NOTE: YOUR ADDRESS BELOW MUST BE CURRENT. THE POSTAL SERVICE WILL NOT FORWARD YOUR LICENSE OR ID NUMBER (optional)GENDER (check one) FEMALEMALEWEIGHT OF CITY OR COUNTY OF RESIDENCE COUNTY OFCITYSOCIAL SECURITY NUMBER (SSN)BIRTHDATE (mm/dd/yyyy)FULL LEGAL NAME (last, first, middle, suffix)EYE COLORHAIR COLORIF YOUR NAME HAS CHANGED, PRINT YOUR FORMER NAME HERE APPLICANT INFORMATIONSTREET ADDRESS APT NO. CITY STATE ZIP CODEHEIGHT FT. ADDRESS (if different from above - this address will show on your LICENSE /permit/ID) APT NO.

All males under the age of 26 are required to check one of the following. Failure to provide a response will result in denial of your application.

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