
A Public Service Agency
CALIFORNIA IDENTIFICATION CARD OR SENIOR IDENTIFICATION CARD
RENEWAL BY MAIL ELIGIBILITY INFORMATION
INSTRUCTIONS
(Please use Blue or Black ink.)
If your last TWO identication card renewals or your LAST Senior identication card renewal was by mail or by Internet, you are NOT eligible to renew by mail or online. You MUST
provide your Social Security Number when applying.
Are you Eligible for Renewal by mail? YES NO
A. Do you have a Social Security Number?
B. Has your identication card been expired for more than one year?
C. Are you changing/correcting your name?
D. Are you 62 years old or older and want a FREE Senior identication card?
A banner with the words “Senior Identication Card” will be printed on the front of the identication card. There is “NO FEE” for a Senior Identication card.
If you answered YES to questions B and C, you are not eligible for renewal by mail. Make an appointment to visit your local DMV oce to renew in person.
If you answered YES to questions A and D, you are eligible for renewal by mail. Complete the attached form.
DISCLOSURES
VETERAN STATEMENT
By marking the veteran box on this application, I certify that I am a veteran of the United States Armed Forces and that I want to receive veteran benets information from the California
Department of Veterans Aairs (CalVet). By marking the veteran box on this application, I also consent to DMV transmitting my name and mailing address to CalVet for this purpose only,
and I certify that I have been notied that this transmittal will occur.
ORGAN DONOR STATEMENT
If you marked ‘Yes’ to register as an organ and tissue donor, you are legally authorizing the recovery of organs and tissues in the event of your death. Registering as a donor will not aect
your medical treatment in any way. As outlined in the California Anatomical Gift Act, your authorization is legally binding and, unless the donor is under 18 years of age, your decision does
not require the consent of any other person. For registered donors under 18 years of age, the legal guardian shall make the nal donation decision. You may limit your donation to specic
organs or tissues, place usage restrictions (for example transplantation or research), obtain more information about donation, or remove your name from the registry on the website of Donate
Life California: www.donateLIFEcalifornia.org. By registering as an Organ Donor, you are giving your consent to allow DMV to electronically transmit your true full name, residence or
mailing address, year of birth, and California driver license or identication card number to Donate Life California. By signing this form, you consent to this process and have been notied
that this transmittal will occur.
VOTER REGISTRATION
• If sharing your address could put you in life-threatening danger, you may be eligible to register to vote condentially. For more information, contact the Safe at Home program
at (877) 322-5227 or visit www.sos.ca.gov/safeathome/.
• For U.S. citizens only. If you indicate that you are eligible to vote, the DMV will send all of the voter registration information collected on this form, including your digital signature,
to the Secretary of State. The oce where you registered will remain condential and will be used only for voter registration purposes.
• If you are eligible to vote and decline to register to vote, your decision will remain condential; however this information will be sent to the Secretary of State to be used only for
voter outreach and registration purposes.
• Voter registration information provided on this application is condential. The DMV does not make voter eligibility determinations.
• If you have not received voter registration information within four weeks of registering, contact your county elections ocial or the Secretary of State.
• Please visit voterstatus.sos.ca.gov/ for more information about your voter registration or www.sos.ca.gov for general information.
CRIMINAL PROSECUTION
• If you submit fraudulent information, the DMV may pursue criminal prosecution.
• Any person who uses false documents to conceal their true citizenship or resident alien status is guilty of a felony pursuant to California Penal Code §114.
FINANCIAL RESPONSIBILITY
• Financial responsibility (commonly known as insurance) is required on all vehicles operated or parked on California roadways. You must carry evidence of nancial responsibility
in your vehicle at all times and it must be provided when: requested by law enforcement, renewing vehicle registration, the vehicle is involved in a trac collision.
• If you cannot aord liability insurance, you may be eligible for the California Low Cost Automobile Insurance Program. Additional information is available at www.mylowcostauto.com
or by calling (866) 602-8861.
PAYMENTS / REFUNDS
• Visit www.dmv.ca.gov to review payment options at your local DMV eld oce. If you are mailing your renewal, payment must be by check. (Checks should be payable to DMV).
• Once this application form and fee have been submitted, no refunds will be made.
PRIVACY NOTICE
• DMV uses the information on this form to determine your eligibility for a Driver License or Identication Card and for the administration of driver license laws.
• Information provided to DMV on this form is collected and subject to the limitations in the Information Practices Act (Civil Code 1798 et seq.), the Driver’s Privacy Protection Act
(18 U.S.C. 2721-2725), the California Vehicle Code (CVC) and other applicable state and federal laws and regulations.
• DMV veries the information and documents you provide with other governmental agencies.
• All information on this form is mandatory except where noted. DMV may deny your application for not providing the required information. Failure to provide the information required
on this form is cause for refusal to issue a driver license or identication card, or, in some cases, cancellation or withdrawal of the driving privilege.
• DMV shares your information with other governmental agencies, law enforcement, and commercial entities as authorized by law. You may obtain a copy of your record at www.dmv.ca.gov
or at any DMV eld oce during regular oce hours. For assistance with access to your record, call (800) 777-0133 or make an appointment to visit a DMV eld oce during regular busi-
ness hours. For assistance with corrections to your record, contact DMV’s Licensing Operations Division Mandatory Actions Unit at (916) 657-6525.
• Questions regarding your Driver License or Identication Card should be addressed to: Driver License Inquiries, Department of Motor Vehicles, PO Box 942890, Sacramento, CA 94290-0001.
• For more information regarding specic CVC Sections or how DMV shares your information, please visit www.dmv.ca.gov. You may also request a copy of How Your DMV
Information is Shared (FFDMV 17) Fast Facts brochure from any eld oce.
• DMV’s Privacy Policy is located at www.dmv.ca.gov under the “Privacy Policy” link at the bottom of the page.
• Questions regarding this notice should be addressed to: Department of Motor Vehicles, ATTN: Chief Privacy Ocer – MS F127, PO Box 932328, Sacramento, CA 94232-3280.
CERTIFICATIONS
• I agree to submit to a chemical test of my blood, breath, or urine for the purpose of determining the alcohol or drug content of my blood when testing is requested by a peace
ocer acting in accordance with California Vehicle Code (CVC) §23612.
• I am hereby advised that being under the inuence of alcohol or drugs, or both, impairs the ability to safely operate a motor vehicle. Therefore, it is extremely dangerous to human life to
drive while under the inuence of alcohol or drugs, or both. If I drive while under the inuence of alcohol or drugs, or both, and as a result, a person is killed, I can be charged with murder.
• By signing this application, I certify that I was notied that if I am under 21 years of age, I cannot legally drive with a blood alcohol concentration (BAC) of 0.01% or more. Driving
with a BAC of 0.01% or more, or refusing to take, or failing to complete an alcohol screening or drug test, results in a one-year suspension of my driving privilege.
• By signing this application, I certify that I was notied that if I am currently on court probation for a driving under the inuence oense, I cannot legally drive with a BAC of 0.01%
or more. Driving with a BAC of 0.01% or more results in a one-year suspension of my driving privilege. Refusing to take, or failing to complete an alcohol screening or chemical
test will result in a two to three year suspension/revocation of my driving privilege.
• I am the person whose name appears on the front of this form. The mailing address shown is valid, existing, and accurate. I agree to accept service of process at this mailing
address according to §§415.20(b), 415.30(a), and 416.90 of the California Code of Civil Procedure.
• I understand DMV may add trac convictions reported by other states or jurisdictions to my driving record that may result in sanctions against my California driving privilege.
• By signing this form, I am acknowledging my presence in the United States is authorized under federal law, except as specied in CVC §12801.
• I understand I may have no more than one driver license in my possession or under my control in accordance with CVC §12511.
• By signing this application, I certify that I understand trac signs and signals in accordance with CVC §12800(h).
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