Where Do I Send A Dmv Dl 11 Form Details

DMV Transmittal Form DL 11 is a form used to notify the DMV of any name or address changes. This form must be filled out and sent to the DMV within 10 days of making any changes to your name or address. Failing to do so may result in fines and other penalties. Make sure to fill out this form accurately and completely, or you could face further consequences. For more information on filling out this form, please visit our website.

The table features details about the dmv transmittal form dl 11. It is definitely worth taking a few minutes to study this before starting filling out your document.

QuestionAnswer
Form NameDmv Transmittal Form Dl 11
Form Length2 pages
Fillable?Yes
Fillable fields64
Avg. time to fill out13 min 22 sec
Other namesdmv transmittal, dmv transmittal form dl 11, dmv transmittal forms no download needed california, fill form dl 11

Form Preview Example

A Public Service Agency

TRANSMITTAL FORM

Applicant—Complete Only Sections That Apply

NAME (FIRST, MIDDLE, LAST)

DL or ID NUMBER

SOCIAL SECURITY NUMBER

ADDRESS

CITY

STATE

ZIP CODE

DAYTIME AND EVENING TELEPHONE NUMBER

(

)

(

)

Emancipated Minor

I am an unmarried minor. I am declaring myself emancipated because:

 

 

(Driver License)

_________________________________________________________________________________

 

 

I am also submitting Proof of Financial Responsibility (SR 1P) in lieu of a guarantor’s signature.

 

My parents are:

 

 

 

 

 

 

 

deceased.

 

 

 

 

 

 

 

nonresidents of California.

 

 

 

 

 

 

 

living (one or both) and are California residents.

 

 

 

 

 

 

Other

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF PARENT (FIRST, MIDDLE, LAST)

ADDRESS

CITY

STATE

ZIP

 

 

 

 

 

 

 

 

NAME OF PARENT (FIRST, MIDDLE, LAST)

ADDRESS

CITY

STATE

ZIP

 

 

 

 

 

 

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

 

true and correct.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE

 

NAME OF PARENT (FIRST, MIDDLE, LAST)

 

SIGNATURE

 

 

 

 

 

 

 

 

X

 

 

Emancipated Minor

Please issue an identiication card to me marked with the word “EMANCIPATED” because:

 

(ID Card)

 

I have entered into a valid marriage. (Civil Code Section 62)

 

 

 

 

 

 

 

 

I am on active duty in the Armed Forces. (Civil Code Section 62)

 

 

 

 

of a Declaration of Emancipation. (Family Code Sections 7120—7123)

 

 

 

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

 

true and correct.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE

 

NAME OF PARENT (FIRST, MIDDLE, LAST)

 

SIGNATURE

 

 

 

 

 

 

 

 

X

 

 

Consent for

I am the _____________________________of ___________________________________________

Issuance

 

RELATIONSHIP

 

NAME OF MINOR

 

 

 

 

 

 

 

(Parents Not

and, as such, a person required to sign and verify a minor’s application for a driver license. I consent to

Accepting

the issuance of a driver license to this minor provided the minor’s application is accompanied by proof of

Civil Liability)

inancial responsibility as deined by the California Vehicle Code (CVC). I do not consent to accept the

 

civil liability speciied in CVC §17707 and §17708.

 

 

 

 

 

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

 

true and correct.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE

 

NAME OF PARENT (FIRST, MIDDLE, LAST)

 

SIGNATURE

 

 

 

 

 

 

 

 

X

 

 

Acceptance of

This minor resides with me and my relationship to this minor is _____________________________

Liability For Minor

 

 

 

 

 

 

 

 

(Dependent or

• I am age 18 or over and a resident of California,

 

 

 

 

ward of the court)

• This minor is a dependent or ward of the court,

 

 

 

 

I consent to the issuance of an original or duplicate driver license to this minor,

I assume the liability speciied in California Vehicle Code §17707 through §17710.

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

DATE

NAME OF PARENT (FIRST, MIDDLE, LAST)

SIGNATURE

X

DL 11 (REV. 8/2009) WWW

TRANSMITTAL FORM

Applicant—Complete Only Sections That Apply

NAME (FIRST, MIDDLE, LAST)

DL or ID NUMBER

SOCIAL SECURITY NUMBER

ADDRESS

CITY

STATE

ZIP CODE

DAYTIME AND EVENING TELEPHONE NUMBER

(

)

(

)

Long Standing

I have a long standing vision condition in my right eye only left eye only since _______________

Stable Vision

because of a:

 

 

 

Condition Statement

 

 

 

 

 

vision disorder: __________________________________________________________________

 

trauma or accident: _______________________________________________________________

 

DMV has this information along with documentation from my eye doctor.

Yes

No

 

If no, attach the Report of Vision Examination (DL 62).

 

 

 

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

 

true and correct.

 

 

 

 

 

 

 

 

 

DATE

SIGNATURE

 

 

 

 

X

 

 

 

 

 

 

 

Utility Form

Use this section to transmit information.

 

 

 

 

 

 

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

 

DATE

 

SIGNATURE

 

 

 

 

 

 

X

 

 

 

 

 

 

 

 

 

Limited Term

Examiner is recommending

Issuance

Extension

Ending a limited term (L/T) license.

Recommendation

 

L/T Years Recommendation ____________________

With Corrective Lenses (Code 01)

 

(Key 10 in Attach Field on TEST RESULTS screen)

 

 

Clearly state the reason for issuing, extending, or ending the limited term DL:

Medical Exam

Applicant is disqualiied

The medical report needs further evaluation because:

Report Review

Recommendation

 

(Send to DSAU) Mail Station J234)

A copy of medical report is attached

 

 

 

 

DMV Employee

DATE

EMPLOYEE’S PRINTED NAME/SIGNATURE/ID NO.

OFFICE NAME/ID NO.

 

 

 

 

Signature

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DL 11 (REV. 8/2009) WWW

How to Edit Dmv Transmittal Form Dl 11

We've used the hard work of our best computer programmers to make the PDF editor you may want to work with. Our application will enable you to fill out the dmv transmittal form file without any difficulty and don’t waste time. All you need to do is keep up with these easy recommendations.

Step 1: The following page has an orange button saying "Get Form Now". Select it.

Step 2: After you've accessed your dmv transmittal form edit page, you will notice all options it is possible to use regarding your file at the upper menu.

Provide the required material in each one area to get the PDF dmv transmittal form

dmv transmittal form dl 11 california empty fields to fill in

Fill in the DATE, NAME OF PARENT (FIRST, SIGNATURE, I am the, RELATIONSHIP NAME OF MINOR, and, DATE, NAME OF PARENT (FIRST, SIGNATURE, This minor resides with me and my, I consent to the issuance of an, Consent for, Issuance, (Parents Not, Accepting, Civil Liability), Acceptance of, Liability For Minor, (Dependent or, and ward of the court) areas with any content that is required by the software.

step 2 to completing dmv transmittal form dl 11 california

Jot down the valuable particulars when you find yourself within the DATE, NAME OF PARENT (FIRST, SIGNATURE, and DL 11 (REV area.

dmv transmittal form dl 11 california DATE, NAME OF PARENT (FIRST, SIGNATURE, and DL 11 (REV blanks to complete

The DAYTIME AND EVENING TELEPHONE, Long Standing Stable Vision, I have a long standing vision, Condition Statement, right eye only, left eye only since _________, vision disorder:, trauma or accident:, DMV has this information along, Yes, If no, I certify (or declare) under, DATE, SIGNATURE, Utility Form, and Use this section to transmit section will be the place to place the rights and responsibilities of all sides.

dmv transmittal form dl 11 california DAYTIME AND EVENING TELEPHONE, Long Standing Stable Vision, I have a long standing vision, Condition Statement, right eye only, left eye only since _________, vision disorder:, trauma or accident:, DMV has this information along, Yes, If no, I certify (or declare) under, DATE, SIGNATURE, Utility Form, and Use this section to transmit blanks to insert

End by taking a look at the following fields and preparing them as required: DATE, SIGNATURE, Limited Term, Recommendation, Examiner is recommending, Issuance, Extension, Ending a limited term (L/T), L/T Years Recommendation, With Corrective Lenses (Code 01), (Key 10 in Attach Field on TEST, Clearly state the reason for, Medical Exam Report Review, Applicant is disqualiied, and The medical report needs further.

part 5 to finishing dmv transmittal form dl 11 california

Step 3: Hit the "Done" button. Now, it is possible to transfer the PDF document - upload it to your electronic device or send it by using electronic mail.

Step 4: It can be better to create duplicates of the document. You can rest assured that we will not publish or check out your information.