Dmv Ol 79C Form PDF Details

In order to change your name on your driver’s license in California, you will need to fill out the DMV Form Ol 79C. This form can be obtained from a local DMV office or downloaded from the DMV website. You must provide your full name as it appears on your driver’s license, date of birth, social security number, and current address. There is a fee of $21 to have your name changed on your driver’s license. If you are changing your name due to marriage or divorce, you will also need to provide proof of the change such as a marriage certificate or court order. The deadline to submit the DMV Form Ol 79C for a name change is 30 days after the date of the event. If you do not submit the form within this timeframe, you will need to reapply and pay the fee again. Make sure that you keep a copy of the form for your records. If you have any questions about filling out this form or about changing your name on your driver’s license, please contact the DMV toll-free at 1-800-777-0133.

QuestionAnswer
Form NameDmv Ol 79C Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other names79c form download, ol79c dmv ca form, 79c form get, ol79c form

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STATE OF CALIFORNIA

OCCUPATIONAL LICENSING SECTION

DEPARTMENT OF MOTOR VEHICLES®

NOTIFICATION BY LICENSEE

A Public Service Agency

OUT–OF–BUSINESS REPORT

INSTRUCTIONS FOR LICENSEE:

 

DMV USE ONLY

OCCUPATIONAL LICENSING NUMBER

•Complete Sections 1 – 4.

•Submit notification and surrender supplies as required in Section 3 to DMV Inspector Office; address available at www.dmv.ca.gov,

Offices, Inspector Offices.

SECTION 1 — BUSINESS INFORMATION

BUSINESS NAME

 

OCCUPATIONAL LICENSING NUMBER

 

 

 

 

ADDRESS

CITY

STATE

ZIP CODE

SECTION 2 — DOB INFORMATION

 

LOCATION GOING OUT OF BUSINESS (CHECK ONE BOX)

 

 

 

 

 

 

 

EFFECTIVE DATE

 

 

 

 

Main

Branch

 

Classroom

 

 

 

 

 

 

 

 

 

REPORTED BY

 

 

 

 

 

TITLE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FUTURE CONTACT ADDRESS

 

 

CITY

 

 

STATE

ZIP CODE

FUTURE CONTACT TELEPHONE NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

(

)

 

 

 

 

 

REASON FOR CLOSING BUSINESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION 3 — LIST ALL SUPPLIES SURRENDERED

(Attach separate sheet if additional space is needed.)

 

 

 

 

 

 

 

 

 

 

 

 

 

A. WALL LICENSES — List Occupational Licensing Number below and attach licenses to report.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FORM CONTROL NUMBER (MAIN)

 

FORM CONTROL NUMBER (BRANCH)

 

FORM CONTROL NUMBER (BRANCH)

FORM CONTROL NUMBER (BRANCH)

 

 

 

 

 

 

 

 

 

 

 

 

 

MBL NUMBER (DRIVING SCHOOL INSTRUCTOR)

 

MBL NUMBER (DRIVING SCHOOL INSTRUCTOR)

 

MBL NUMBER (DRIVING SCHOOL INSTRUCTOR)

 

 

 

 

 

 

 

 

 

 

MBL NUMBER (DRIVING SCHOOL INSTRUCTOR)

MBL NUMBER (DRIVING SCHOOL INSTRUCTOR)

 

MBL NUMBER (DRIVING SCHOOL INSTRUCTOR)

 

 

 

 

 

 

 

MBL NUMBER (TRAFFIC VIOLATOR SCHOOL INSTRUCTOR)

MBL NUMBER (TRAFFIC VIOLATOR SCHOOL INSTRUCTOR)

MBL NUMBER (TRAFFIC VIOLATOR SCHOOL INSTRUCTOR)

 

 

 

 

 

 

MBL NUMBER (TRAFFIC VIOLATOR SCHOOL INSTRUCTOR)

MBL NUMBER (TRAFFIC VIOLATOR SCHOOL INSTRUCTOR)

MBL NUMBER (TRAFFIC VIOLATOR SCHOOL INSTRUCTOR)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B. ACCOUNTABLE INVENTORY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REPORT OF SALES, NOTICE TO DISMANTLER, DS/TVS

 

TYPE

 

BUY/SELL HELD

LOST OR STOLLEN

 

UNUSED

 

 

 

OR OTHER NUMBERED CERTIFICATES, ETC.

 

 

FOR REISSUANCE

 

DESTROYED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

#

to

 

 

 

 

 

 

 

 

 

 

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OCCUPATIONAL LICENSING NUMBER IF BUY/SELL REPORT OF SALES ISSUED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OL 79C (REV. 5/2017) WWW

 

 

 

 

 

 

 

 

 

 

*23OL79C*

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DMV USE ONLY

OCCUPATIONAL LICENSING NUMBER

SECTION 3 — LIST ALL SUPPLIES SURRENDERED (Attach separate sheet if additional space is needed.) (continued)

C. SPECIAL PLATES AND REGISTRATION CARDS — List license numbers and attach licenses to report.

PLATE NUMBER(S)

REGISTRATION CARD(S) NUMBER(S)

LOST OR STOLEN SURRENDERED

Y N

Y N

Y N

Y N

Y N

Y N

Y N

Y N

Y N

Y N

Y N

SECTION 4 — LICENSEE CERTIFICATION

Initials

Whenever the department cancels, suspends, or revokes any license issued pursuant to Division 5 (commencing with §11100), the licensee or person in possession shall immediately return the license, documents, plates,certificates, and other evidence of the licensed to the department. California Vehicle Code (CVC) §8803.

I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

PRINTED NAME

SIGNATURE

X

TITLE

DATE SIGNED

SECTION 5 — STOP PLACED AND COMMENTS

No

Yes

COMMENTS

SECTION 6 — INSPECTOR/SUPERVISOR CERTIFICATION

INSPECTOR NAME

INSPECTOR NUMBER

 

 

SIGNATURE

DATE SIGNED

X

 

SUPERVISING INSPECTOR NAME

NUMBER OF ATTACHMENTS

 

 

SUPERVISING INSPECTOR APPROVAL SIGNATURE

DATE SIGNED

X

 

 

 

OL 79C (REV. 5/2017) WWW

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Filling in part 1 in 79c form get

2. The subsequent step would be to complete the next few blanks: REPORT OF SALES NOTICE TO, OR OTHER NUMBERED CERTIFICATES ETC, TYPE, BUYSELL HELD FOR REISSUANCE, LOST OR STOLLEN, UNUSED, DESTROYED, OCCUPATIONAL LICENSING NUMBER IF, OL C REV WWW, and OLC.

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