How to Fill Out Form HSMV 85041

Form HSMV 85041 at a glance

What it is: Division of Motorist Services, Bureau of Commercial Vehicle and Driver Services: ADDRESS CHANGE FORM (For IRP/IFTA Established Place of Business, Residence, or Mailing Address).

Where and when to file: Mailing address changes (only) may be emailed to CVDSSubmit@flhsmv.gov.

A filled-in Form HSMV 85041 example: a registrant changes only the mailing address

Form HSMV 85041 example filled out, example: a registrant changes only the mailing address
Dana Sample, the registrant, files Form HSMV 85041. Only the mailing address changes, so the physical address stays empty. The picture shows the mailing change, and every value in it is made up. The account holder has both an IRP account and an IFTA account. The new mailing address is the Registrant/Licensee's, and Dana is the requestor as the Registrant/Licensee.

How to fill out Form HSMV 85041, box by box

Account Holder, IRP Account and IFTA Account

Form HSMV 85041 example filled out, account Holder, IRP Account and IFTA Account

Enter the Account Holder (Registrant/Licensee) Name.

Enter the IRP Account # and the IFTA Account #.

Enter the Account Holder Email Address.

Old Physical Address and New Physical Address

Form HSMV 85041 example filled out, old Physical Address and New Physical Address

Changing the physical address on file requires supporting documentation, and requests must be submitted by mail.

Updated cab card(s) will be sent to the email address entered in Account Holder Email Address, and a mailing fee will apply for any hard copies.

Enter the Old Physical Address, City and Zip.

Enter the New Physical Address, City and Zip.

Select One for New Physical Address: Residence or Established Place of Business.

If the registrant is a business, the Florida business address will be used for registration purposes only if it meets all the requirements of an “established place of business” as defined by the International Registration Plan (Article II, Definitions).

Otherwise, the Florida residential address of the principal business owner must be verified and will be used as the physical address for registration purposes.

Old Mailing Address and New Mailing Address

Form HSMV 85041 example filled out, old Mailing Address and New Mailing Address

Enter the Old Mailing Address, City and Zip.

Enter the New Mailing Address, City and Zip.

Select One for New Mailing Address: Registrant/Licensee or Authorized Agent.

Print Name, Telephone Number, Signature and Requestor

Form HSMV 85041 example filled out, print Name, Telephone Number, Signature and Requestor

Enter the Print Name and Telephone Number.

Sign on Signature and enter the Date.

Requestor is: Registrant/Licensee or Company Officer (SUNBIZ REGISTRATION REQUIRED).

If your situation is different

Updating the physical address currently on file

Instructions for updating the physical address currently on file: complete and sign Form 85041, make payment for each vehicle requiring a new cab card, and submit three proofs of the new physical address from the applicable list.

Each document must display registrant's name (the individual or the business, if applicable) and the new physical address.

All three documents must be from the same list.

Legible copies are accepted.

Established Place of Business in Florida

Required: Copy of an employer form filed with the IRS (e.g., Forms W-2, W-3, or 941) proving business has at least one employee; the document must have business FEIN, but Social Security numbers should be redacted.

In addition, any two of the following: Document on Florida Department of State, Division of Corporations letterhead addressed to the business (Information copied from the SunBiz website is not acceptable).

Receipt issued by FL Department of Revenue for prior year filing/payment of corporate or payroll taxes.

Business or occupational license issued by a Florida municipality or county (not for virtual office space or shared business services staffed by non-employees).

Property tax assessment issued to the business for the most current tax quarter or year.

Utility bill (electric, gas, water, cable, telephone) issued to the business within the last 90 days.

Different bills may serve as separate proofs if issued by different utility providers.

Bank statement issued to the business within the last 90 days.

Lease agreement for the commercial property occupied by the business.

Residence in Florida

If registrant does not have or is not an Established Place of Business in Florida (as defined by IRP), the registrant (individual or principal owner of the business) must demonstrate Florida residency.

Required: Registrant's (unexpired) Florida driver's license or Florida identification card.

IRS receipt for filing/paying personal federal income taxes for most current tax year.

Bank statement issued to the registrant within last 90 days.

Real estate or property tax bill issued to the registrant in the most current tax year.

The registrant's Florida vehicle title or Florida vehicle registration for a vehicle titled in Florida.

Tenant lease agreement for an apartment or other residential property or affidavit from property owner if there is no formal lease agreement.

Sources

[1] Form HSMV 85041 (Rev 9/2021), Address Change Form, Florida Department of Highway Safety and Motor Vehicles (the Official source link on this page).

HSMV 85041 PDF Details

Requests must be submitted by mail; mailing address changes (only) may be emailed to CVDSSubmit@flhsmv.gov.

Three proofs: submit three proofs of the new physical address from the applicable list. All three documents must be from the same list.

Each document: must display registrant's name (the individual or the business, if applicable) and the new physical address.

Business: the business address will be used only if it meets all the requirements of an established place of business as defined by the International Registration Plan.

Otherwise: the Florida residential address of the principal business owner must be verified and will be used as the physical address for registration purposes.

QuestionAnswer
Form NameHSMV 85041
Form Length2 pages
Fillable?Yes
Fillable fields25
Avg. time to fill out5 min
Edition9/2021
Issuing agencyDivision of Motorist Services, Bureau of Commercial Vehicle and Driver Services
Mailing address changes onlyMay be emailed to CVDSSubmit@flhsmv.gov
Other namesHSMV 85041, HSMV85041, 85041, Form 85041, Address Change Form
Official sourceHSMV 85041 (Rev 9/2021), Division of Motorist Services, Bureau of Commercial Vehicle and Driver Services