Dmv Dld 128 Form PDF Details

The DMV DLD 128 form is a document that you need to fill out in order to apply for a driver's license in the state of California. This form is simple to fill out, and contains all of the information that the DMV needs in order to process your application. Make sure that you provide accurate information on this form, as any mistakes can delay the processing of your application. The DMV will also use the information on this form to determine whether or not you are eligible for a driver's license. If you have any questions about how to complete this form, be sure to consult with a DMV representative before submitting it.

QuestionAnswer
Form NameDmv Dld 128 Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesid for homeless, how can a homeless person get an id in florida, declaration of homelessness florida, florida dmv homeless declaration form pdf

Form Preview Example

Field Services Division

Reno/Sparks/Carson City (775) 684-4DMV (4368)

Las Vegas Area (702) 486-4DMV (4368)

Rural Nevada (877) 368-7828

Fax: (775) 684-4992

Website: www.dmvnv.com

DECLARATION OF HOMELESS STATUS

I hereby certify under penalty of perjury that I am homeless and qualify for the waiver of fees for a duplicate Driver’s License, Instruction Permit, or Identification Card, as prescribed in Nevada Revised Statutes Chapter 483.

I understand that the fees will be waived not more than one time and that I will be required to reimburse the Department the amount of the photo fee at the time of my renewal, if I am employed at the time.

I am requesting a duplicate

Driver’s License

Identification Card

Instruction Permit

Applicant’s Printed Name _____________________________________________________

Driver License/Identification Card Number (if known) _______________________________

Social Security Number ______________________________________________________

Date of Birth _______________________________________________________________

Address Where I Am Staying

 

 

__

________

 

City

 

 

State:

 

Zip:

____

Signature of Applicant _______________________________________________________

Dated this ________________ day of ______________________________, 20__________

DMV Representative ________________________________________________________

Dated this ________________ day of ______________________________, 20__________

DLD- 128 (July 2005)

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Part no. 1 for filling out homeless driver's license

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DMV Representative, Signature of Applicant, and Identification Card of homeless driver's license

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