Dmv Address Change Form – Fill Out and Use This PDF

INSTRUCTIONS/DISCLOSURES

•Complete online at www.dmv.ca.gov or mail to: DMV CHANGE OF ADDRESS P. O. Box 942859 Sacramento, CA 94259-0001.

•Enter the information as shown on the document, i.e. California driver license (DL), identification (ID) card, or vehicle registration (VR) card, for which a change is being requested.

•Names not matching DMV records and/or unreadable information cannot be updated.

•For DL/ID card(s): Type or write your new address on a small piece of paper with your signature and date; keep it with your DL or ID card.

•For VR write your new address on your registration card and initial.

•A commercial licensed driver must maintain a California residence address or the driver license will be downgraded to non commercial status.

•Section 5 - Use additional forms if necessary. For multiple business vehicles, attach a list on company letterhead.

VOTER REGISTRATION

•If sharing your address could put you in life-threatening danger, you may be eligible to register to vote confidentially. 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 office where you registered will remain confidential 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 confidential; 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 confidential. 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 official 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 financial 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 traffic collision.

•If you cannot afford liability insurance, you may be eligible for the California Low Cost Automobile Insurance Program. Additional information is avail- able at www.mylowcostauto.com or by calling (866) 602-8861.

PRIVACY NOTICE

•DMV uses the information on this form to determine your eligibility for a Driver License or Identification 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 verifies 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 identification 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 field office during regular office hours. For assistance with access to your record, call (800) 777-0133 or make an appointment to visit a DMV field office during regular business 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 Identification Card should be addressed to: Driver License Inquiries, Department of Motor Vehicles, PO

Box 942890, Sacramento, CA 94290-0001.

•For more information regarding specific 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 field office.

•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 Officer – 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 officer acting in accordance with California Vehicle Code (CVC) §23612.

•I am hereby advised that being under the influence 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 influence of alcohol or drugs, or both. If I drive while under the influence 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 notified 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 notified that if I am currently on court probation for a driving under the influence offense, 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 traffic 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 specified 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 traffic signs and signals in accordance with CVC §12800(h).

DMV 14 (REV. 10/2018) WWW

Please Print Characters In Capital Letters Using Black or Dark Blue Ink only.

1. Personal or

LAST NAME OR BUSINESS NAME

DRIVER LICENSE/ID CARD NO. (FOR

Business

DL/ID CHANGE OF ADDRESS ONLY)

Information

FIRST

INITIAL

BIRTH DATE (FOR DL/ID CHANGE OF ADDRESS ONLY)

2.

Previous

STREET NUMBER ONLY

STREET NAME (INCLUDE ST., AVE., RD., CT., ETC.)

Residence

or Business

Address

APT NO.

CITY - DO NOT ABBREVIATE - USE FIRST 22 CHARACTERS IN CITY NAME

STATE

ZIP CODE

3. New or

STREET NUMBER ONLY

STREET NAME (INCLUDE ST., AVE., RD., CT., ETC.)

Correct

Residence

or Business

APT NO.

Address

Do Not Use

P.O. Box in

CITY - DO NOT ABBREVIATE - USE FIRST 22 CHARACTERS IN CITY NAME

STATE

ZIP CODE

this space.

4. New or

STREET NUMBER ONLY

P.O. BOX OR STREET NAME OR STREET NAME AND PRIVATE MAIL BOX (PMB)

Correct

Mailing

Address

APT NO.

If Different

From Address

in Section 3

CITY - DO NOT ABBREVIATE - USE FIRST 22 CHARACTERS IN CITY NAME

STATE

ZIP CODE

4a.Voter

Change Of

Your voting address will be updated unless you check the box below.

Address

Use only with

Check this box if you do not want your new address used for voter registration purposes.

DL/ID Change

of Address

5.

Vehicles,

CALIFORNIA PLATE/CF/PLACARD NO.

LAST 17 POSITIONS OF VEHICLE ID OR VESSEL HULL ID NUMBER

CHECK IF

CHECK IF REGISTERED

Vessels,

LEASED

OUTSIDE CA

or Placards

Owned By

You

6.Leased LEASING COMPANY’S NAME

Vehicles

7. Location of

STREET NUMBER ONLY

STREET NAME (INCLUDE ST., AVE., RD., CT., ETC.)

Trailer Coach

or Vessel

If Different

CITY - DO NOT ABBREVIATE - USE FIRST 16 CHARACTERS IN CITY NAME

COUNTY – DO NOT ABBREVIATE

From

Residence

or Business

Address

IMPORTANT: CONTINUE TO NEXT PAGE.

YOUR APPLICATION CANNOT BE PROCESSED WITHOUT BOTH PAGES.

*DMV141*

DMV 14 (REV. 10/2018) WWW

If you are enrolled in a confidential address program, such as Safe At Home, or are only updating your vehicle, vessel, or placard address, skip to Section 10.

SECTION 8 — VOTER REGISTRATION— FOR U.S. CITIZENS ONLY.

It is a crime to intentionally provide incorrect information on a voter registration form.

(State law requires eligible citizens be automatically registered to vote, unless they choose not to in this section.)

8a. Are you a United States citizen?	Yes	No
If you answered “No,” you cannot register to vote. Skip to Section 10.

Voter Registration Requirements

If you answered “YES” to all of the voter registration requirements listed below, you can register to vote:

•I am a United States citizen

•My residence address is in California

•I am at least 18 years old (You may pre-register if you are 16 or 17, but you must be 18 or older to vote on Election Day.)

•I am not currently in state or federal prison or on parole for the conviction of a felony

•I am not currently found mentally incompetent to vote by a court

8b. Do you meet ALL of the voter registration requirements listed above?

Yes

No

•If you answered “No,” you cannot register to vote. Skip to Section 10.

•If you answered “Yes” to the above questions, you will be registered to vote. You can choose not to register by checking the box below.

8c. I am eligible, but I do not want to register to vote or update my voter registration information. Skip to Section 10.

•Do not check this box if you want to register to vote or update your voter registration information. Continue to Section 9.

ONLY COMPLETE IF YOU ARE UPDATING YOUR DL OR ID ADDRESS.

SECTION 9 — VOTER PREFERENCES— FOR U.S. CITIZENS ONLY.

(To choose or update any voter preferences, you must first indicate you are eligible to vote in Section 8 above.)

Do you want to get your ballot by mail before each election?

Yes

No

If you answer “Yes,” you will receive a vote-by-mail ballot for all elections. You can always vote in person by turning in your vote-by-mail ballot, or voting a provisional ballot, at your polling place.

In what language would you like to receive election materials? (Select only one.)

English	Chinese	Tagalog	Thai	Khmer
Spanish	Korean	Hindi	Japanese	Vietnamese

Contact Information for voter registration. (Optional)

Telephone Number: (EXAMPLE: 916-555-1212)

I want to remove my telephone number.

Email address: (EXAMPLE: john.doe@company.com)

I want to remove my email address.

If you do not receive a voter notification card within four weeks, contact your county elections official.

You can also check your voter registration status at https://voterstatus.sos.ca.gov/.

SECTION 10 — CERTIFICATION

Your mailing address may be given to requesters providing a valid reason for requesting the information. If you receive mail at your residence, then giving DMV a separate mailing address is optional. Your residence address is restricted to authorized requesters per Vehicle Code Section 1808.21. I am the person whose name appears on the record(s) above and the mailing address shown is valid, existing and accurate. I consent to receive service of process at this mailing address pursuant to 415.20(b), 415.30(a), and 416.90 of the Civil Procedure Code. I certify (or declare) under penalty of perjury under the laws of the State of California that the information I provided is true and correct.