Transcription of Notice of Surrender - dol.wa.gov
1 XNotice of SurrenderYou can use this form to Surrender your Washington state or out-of-state driver license, ID, and/or or PRINT Name (Last, First, Middle) Date of birthThis is to acknowledge that the Surrender of my license is: voluntary mandatoryWashington stateLicense /ID numberI am surrendering my: Driver license/ID Enhanced driver license/ID Motorcycle endorsement Temporary driver licenseOut-of-stateState License /ID numberI am surrendering my: Driver license/ID Motorcycle endorsement Temporary driver licenseI understand that in order to be relicensed or regain a surrendered endorsement, I must meet the requirements of Chapter RCW, including payment of all appropriate fees and qualification of all required attest that this, my e-signature.
2 Is intended to certify and acknowledge my agreement to the terms of this and any additional driver license applications I am submitting as part of this transaction and that my e-signature will be applied to all such and place signed SignatureFor department use onlyCommentsLSR Station RCW DLE-520-011 (R/7/16)VWEA
