Form Adm 9050 PDF Details

There are many forms that an individual may have to fill out when dealing with the Internal Revenue Service, and Form Adm 9050 is one of them. This form is used to request relief from certain penalties and interest assessed by the IRS. It can be a helpful tool for taxpayers who have made an honest mistake on their return or have been affected by a natural disaster. Learning about Form Adm 9050 and how to use it can help taxpayers avoid costly penalties and interest charges.

You will see information regarding the type of form you want to prepare in the table. It will show you the length of time you will require to fill out form adm 9050, what fields you will need to fill in and some additional specific facts.

Form NameForm Adm 9050
Form Length1 pages
Fillable fields0
Avg. time to fill out15 sec
Other namesadm 9050, sample of how to fill out adm 9050 form, adm9050, adm 9050 dmv form

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O l number



PrInCIPAl’s True Full nAme(s) AnD DbA(s)




As Principal, who has applied for a license as a


, hereby appoint(s) the Director of Motor Vehicles


TyPe lICense

as principal’s true and lawful agent upon whom all process may be served in any action, or actions which may hereafter be commenced against said principal, arising out of any claim for damages suffered by any firm, person, association, organization, corporation or limited liability partnership, or company, by reason of the violation by said principal of any of the terms and provisions of the California Vehicle Code or any condition of the bond.

Principal further stipulates and agrees that, when personal service of process upon principal cannot be made in this State after due diligence, that service can be made upon the Director of Motor Vehicles. In the event of the Director’s absence from his/her office, that service can be made upon any employee of the State of California in charge of the Director’s office, and that such service of process shall be of the same legal force and effect as if served upon the principal personally.

The principal further stipulates and agrees that the agency created by said appointment shall continue for and during the period covered by any license that may be issued by the Department of Motor Vehicles, and so long thereafter as the principal may be made to answer in damages for a violation of the California Vehicle Code, or any condition of principal’s bond. The principal further agrees that for purposes of venue, whenever service is made upon the Director, the service shall be deemed to have been made upon principal in the county in which principal has or last had his/her established place of business.

IN WITNESS WHEREOF, the said principal has hereunto set his hand the






Clear Form

A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document, to which this certificate

is attached, and not the truthfulness, accuracy or validity of that document.

State of California





County of










before me,




personally appeared




who proved to me on the basis

of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument, and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies) and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.

I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct.

WITNESS my hand and official seal.

sIGnATure OF nOTAry



On this day,


, at this city,



I witnessed the signature of

the Principal, who based on satisfactory identification, executed under authorized capacity their

signature before me.

I certify under penalty of perjury under the laws of the State of California that the foregoing paragraph is true and correct.

DePArTmenT OFFICIAl nAme & TITle


Officers and employees of the Department of motor Vehicles (DmV) and the Department of the California Highway Patrol (CHP) are, for the purposes of

this code, authorized to administer oaths and acknowledge signatures, for which no fee shall be charged.

CVC section 18

The instrument appointing the director as agent for the applicant for service of process shall be acknowledged by the applicant before a notary public. CVC sections 11102(a)(5)(C), CVC 11202(a)(6)(C), 11403(d), 11710(d)

ADm 9050 (reV. 7/2015) www

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