Form INF 1102 at a glance
What it is: Commercial or Government Employer Pull Notice Enrollment of Out-of-State Licensed Drivers (INF 1102).
Who signs: An original signature is required from the Authorized Representative.
This form is to be used solely for the purpose of enrolling drivers with an out-of-state license into the EPN program.
All Employer Pull Notice (EPN) applicants must complete this enrollment form in its entirety to avoid processing delays.
What to bring and attach to Form INF 1102
A copy of the out-of-state driver license must be attached for all enrollments.
If you pay the fee for a driver on a Commercial EPN account, checks must be made out to the California Department of Motor Vehicles (DMV) and submitted with this enrollment form.
A filled-in Form INF 1102 example: a freight company enrolls one Oregon driver
How to fill out Form INF 1102, box by box
Section 1, employer information
Section 1 - Employer Information: in Company Legal Name/Agency Name/Sole Proprietor Name, list the legal name of the company, agency name, or sole proprietor.
In Requester Code, provide the assigned EPN Requester Code issued by the DMV (if no Requester Code assigned yet leave blank). Incorrect Requester Codes will cause rejection of the enrollment form.
In Mailing Address, provide the agency/company's full mailing address with city, state, and zip code on the EPN account.
In Contact Person, list the person(s) within the company/agency who can contact EPN regarding the company's EPN account.
In Telephone Number, provide the business telephone number.
Section 2, driver information
Section 2 - Driver Information: up to 4 drivers may be added per form.
In Full Legal Name, provide the driver's complete legal name (last, first, and middle name) as it appears on their DL. Do not use initials. If no middle name you must enter “NMN”.
In Date of Birth, provide the month, day, and year driver was born (e.g. 01/12/1962).
In Home State Address, provide the driver's home state address, including city, state and zip code. It must not be a CA address.
In Out-of-State Driver License Number, provide the complete DL Number issued to the driver from their home state. If the driver has a previously issued CA DL Number, or “X” number, please complete INF 1100 form.
In Issuing State, provide the state where the out-of-state DL was issued.
Remarks is an optional field for employers to add information to the Driver Record Report (DL 414), for example: terminal site, vehicle plate/VIN, employee identification number, or out-of-state DL Number. The driver's name, DOB, or Social Security Numbers will not be keyed. (Maximum 21 characters)
If the driver is enrolled on a Commercial EPN account, attach a check or money order for each new driver to the form. Checks must be made out to the CA DMV.
Section 3, certification
Printed Name: The printed name of the Authorized Representative signing the form; must be the individual within the company/agency who is responsible for managing the EPN account.
Section 3 - Certification (Original Signature Required): this section must be signed by the Authorized Representative.
Date: Provide date the enrollment form is being signed.
By signing you certify (or declare) under penalty of perjury under the laws of the State of California that it is true and correct.
The driver(s) are (1) mandated for enrollment under California Vehicle Code §1808.1. OR (2) have signed an Authorization for Release of Driver Record Information form (INF 1101).
More rules for Form INF 1102
A Driver Record Report (DL 414) will be generated and mailed to the employer within ten (10) business days from the date of enrollment for newly enrolled drivers, and upon action/activity or annually for currently enrolled drivers.
Any changes made to the EPN account (e.g. mailing address or contact information) must be submitted to EPN on a Notice of Change form (INF 4).
Form will not be processed if incomplete or missing information.
It is the employer's responsibility to delete enrolled drivers immediately upon termination of employment.
For processing time, please allow up to 30 days from the date the application is received in the unit.
Keep a copy of the completed form for your records.
Common questions about Form INF 1102
Where do I file it?
Please mail the completed form(s) with original signature and related fees to: Mailing Address: Department of Motor Vehicles EPN Program - H265 P.O. Box 944231 Sacramento, CA 94244-2310 Overnight Address: Department of Motor Vehicles EPN Program - H265 2415 First Avenue Sacramento, CA 95818
Are there fees?
Pay the required $5 fee for each enrolled driver on a Commercial EPN account (checked November 8, 2026).
Sources
[1] Form INF 1102 (REV. 7/2018), California Department of Motor Vehicles (the Official source link on this page).