Form 500-001 at a glance
What it is: Form 500-001 is the Restricted Driver License Application.
Who signs: Print the completed form and sign here.
What to bring and attach to Form 500-001
Proof of financial responsibility - the most common method is by filing a form called an SR-22. You can get one from most automobile insurance agents. If you are suspended for an alcohol or drug-related offense, contact an ignition interlock company that installs Washington certified devices. They will send proof of installation. If your employment requires you to drive a vehicle during working hours that is owned, leased, rented, or the temporary responsibility of your employer, it may be exempt. You must carry a signed Employer Declaration for Ignition Interlock Exemption (DR-500-025), available at dol.wa.gov. If you are indigent, you may be eligible for assistance with costs of ignition interlock device installation, removal, and leasing. To apply, submit a Financial Assistance Application (DR-500-024) located at dol.wa.gov.
A filled-in Form 500-001 example: a driver applies after a suspension
How to fill out Form 500-001, box by box
Name, Driver license number, Date of birth and Address
Print or type your Name (Last, First, Middle initial), your Driver license number and the State/Jurisdiction.
Enter your Date of birth, your 10-digit daytime phone number, your Height, your Weight and your Eye color.
Mark M, F or X.
Under Address, enter the Street address or PO Box, City, State, Zip code.
Answer and signature
Answer Yes or No: I have read the information and agree to all terms and conditions. Sign under Signature.
If your situation is different
Who applies, where to mail it and the fee
Use this form to apply for a temporary restricted driver license if your driving privilege in Washington is currently suspended or revoked. To apply, take this completed application and a $100 nonrefundable application fee to any driver licensing office or mail your application with a check or money order payable to the Department of Licensing to: Application and Issuance Department of Licensing PO Box 3907 Seattle, Washington 98124-3907 (checked November 7, 2026).
Proof within 30 days
Proof of the SR-22 insurance and any other required documentation must be received within 30 days of receiving this application. If not, you must submit a new application and another $100 fee (checked November 7, 2026).
Eligibility/Restrictions
What type of temporary restricted license you qualify for will be determined based on an evaluation of your driving record. Any restricted license issued will only be valid within the state of Washington and cannot be used to operate a commercial motor vehicle. Where and when you can drive may also be restricted. Your suspension / revocation cannot be for a minor in possession, intermediate license violations, failure to pay child support, fraud, violation of court-ordered probation, medical or vision reasons, habitual traffic offender status, failure to enter into or comply with a required alcohol / drug treatment program, or vehicular assault or homicide (except under certain conditions). You must be a Washington licensed driver or hold a valid out-of-state driver license. The restricted license is only legal within the state of Washington. A second application fee is not required for a new suspension based on the same incident date.
Keeping your restricted license
Your restricted driver license will be cancelled if any of the following occurs: You are convicted of violating the restrictions. Your driving privilege is suspended or revoked while your restricted license is in effect. Evidence is received that your reason for driving is no longer valid. Notification is received that your financial responsibility (SR-22) is cancelled. Notification is received that your ignition interlock device is no longer functioning or has been removed.
Sources
[1] Form 500-001 (Revised June 2024), Restricted Driver License Application, Washington State Department of Licensing (the Official source link on this page).