Transcription of Form 4595 - Application for Limited Driving Privilege
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Form 4595 - Application for Limited Driving Privilege
Driver License Number Date of Birth (MM/DD/YYYY) ___ ___ / ___ ___ / ___ ___ ___ ___Name (Last, First, Middle Initial) Social Security Number | | | | | | | | Street Address (Do not use Box) City, State, ZIP CodeMailing Address (If different from street address) City, State, ZIP CodeE-mail Address Phone NumberIf the Application is approved, an order granting the Limited Driving Privilege will be mailed to you.
If the application is approved, an order granting the limited driving privilege will be mailed to you. You must carry the original copy of the Limited Driving Privilege Notice with you when operating a motor vehicle. ... Form 4595 - Application for Limited Driving Privilege
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