Understanding the nuances of the DMV INF 1102 form is crucial for businesses that employ drivers with out-of-state licenses. This form serves as the cornerstone for the Commercial Employer Pull Notice Program by the Department of Motor Vehicles Office of Information Services, highlighting its pivotal role in reinforcing public safety and regulatory compliance. Designed exclusively for enrolling drivers, it facilitates the monitoring of their driving records, ensuring that individuals operating vehicles on behalf of a company maintain a satisfactory level of driving competency and safety. The process requires employers to submit detailed information, including the current address, requester code, contact person's details, and specifics regarding each driver's license class and endorsements. Employers are mandated to certify their compliance with California Vehicle Code §1808.1 or confirm that drivers have granted authorization for the release of their driving records, encapsulating the dual purpose of adherence to legal obligations and promotion of road safety. With a nominal enrollment fee per driver, the procedure underscores the financial and administrative aspects of maintaining a compliant and secure driving workforce. As such, the DMV INF 1102 form represents a critical element in the overarching framework of employment and vehicle operation regulation within California.
| Question | Answer |
|---|---|
| Form Name | Dmv Inf 1102 Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | employer pull notice, ca inf licensed, pull licensed, inf 1102 |
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COMMERCIAL EMPLOYER PULL NOTICE |
A Public Service Agency |
ENROLLMENT OF OUT OF STATE LICENSED DRIVERS |
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Department of Motor Vehicles
Ofice of Information Services
Employer Pull
(THIS FORM IS FOR ENROLLING DRIVERS ONLY)
Please type or print in ink
Sacramento, CA
EMPLOYER
CURRENT ADDRESS
CITY |
STATE |
ZIP CODE |
REQUESTER CODE |
DATE |
TELEPHONE |
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Ext. |
CONTACT PERSON’S NAME AND TITLE (FIRST, MI, LAST)
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CLASS LICENSE |
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A - Class A |
B/P - Class B with passengers |
C/S - Class C with Special Certiicates |
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B - Class B |
C/H - Class C with Hazardous Materials Endorsement |
C/P - Class C with PUC permit issued |
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PRINT AS SHOWN ON |
(“REMARKS” FOR YOUR USE (LIMIT TO 21 SPACES)) |
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1)COMPLETE LAST NAME, FIRST, MIDDLE (DO NOT USE INITIALS) |
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BIRTH DATE |
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(HOME STATE ADDRESS) |
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CITY |
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STATE |
ZIP CODE |
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DRIVER LICENSE NO. |
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CLASS LICENSE |
REMARKS |
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2)COMPLETE LAST NAME, FIRST, MIDDLE (DO NOT USE INITIALS) |
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BIRTH DATE |
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(HOME STATE ADDRESS) |
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CITY |
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STATE |
ZIP CODE |
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DRIVER LICENSE NO. |
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CLASS LICENSE |
REMARKS |
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3)COMPLETE LAST NAME, FIRST, MIDDLE (DO NOT USE INITIALS) |
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BIRTH DATE |
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(HOME STATE ADDRESS) |
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CITY |
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STATE |
ZIP CODE |
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DRIVER LICENSE NO. |
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CLASS LICENSE |
REMARKS |
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4)COMPLETE LAST NAME, FIRST, MIDDLE (DO NOT USE INITIALS) |
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BIRTH DATE |
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(HOME STATE ADDRESS) |
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CITY |
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STATE |
ZIP CODE |
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DRIVER LICENSE NO. |
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CLASS LICENSE |
REMARKS |
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5)COMPLETE LAST NAME, FIRST, MIDDLE (DO NOT USE INITIALS) |
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BIRTH DATE |
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(HOME STATE ADDRESS) |
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CITY |
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STATE |
ZIP CODE |
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DRIVER LICENSE NO. |
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CLASS LICENSE |
REMARKS |
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___________ TOTAL DRIVERS ADDED (A $5 ENROLLMENT FEE FOR EACH DRIVER WILL BE BILLED TO YOUR ABIS ACCOUNT)
I certify under penalty of perjury, under the laws of the State of California, that driver(s) listed above are (1) mandated for enrollment un- der California Vehicle Code §1808.1. OR (2) have signed an “Authorization for Release of driver Record Information” form (INF 1101) or internal document with similar language AND are currently in an employer/employee relationship AND frequently drive during the course of their employment.
Executed at __________________________________ , __________________________________ , _________________________
CITY |
COUNTY |
STATE |
Date ___________________ Signature |
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Printed name and title ________________________________________________________________________________________
To obtain additional forms and information please visit our website at: http://www.dmv.ca.gov/otherservice/epn
INF 1102 (REV. 12/2003)