Maine Form Mv 16 PDF Details

In Maine, obtaining a state-issued identification card involves completing the Maine MV 16 form, a comprehensive document designed to ensure that all applicants meet state requirements for identification. With a modest fee of $5.00, the form necessitates applicants to demonstrate legal presence in the United States alongside proof of residency within Maine. It asks for detailed personal information, including name, mailing address, physical residence, date of birth, sex, social security number, and physical characteristics like height, weight, hair, and eye color. Additionally, it offers individuals the opportunity to consent to becoming organ and tissue donors, an option marked on the identification card by a small red heart upon agreement. Individuals are prompted to supply their social security number under a specific statute, highlighting the form's alignment with federal privacy laws and the stringent penalties for providing false information. Strict requirements for proof of identity are enforced, necessitating two forms of documentation, with specific instructions regarding the certification and types of documents acceptable. Located at the Bureau of Motor Vehicles License Information in Augusta, this process underscores Maine's commitment to secure identification practices and the facilitation of critical services like organ donation.

QuestionAnswer
Form NameMaine Form Mv 16
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesSecurity, 17-A, DD-214, false

Form Preview Example

Application for State of Maine Identification Card

(Please Print Clearly)

FEE $5.00

To obtain an identification card you must provide proof of legal presence in the United States and

documentation of Maine residency.

Name: ________________________________________________________________________________________________________________

FirstMiddleLast

Mailing Address: ______________________________________________________________________________________________________

Physical Residence: ___________________________________________________________________________________________________

Date of Birth: ____/____/____ Sex:

Male Female

Social Security Number: __________________________________

Height: ________Ft. ________In.

Weight: ________ lbs.

Hair Color: _____________ Eye Color: _____________

Telephone Number: _______________________

If you wish to be an organ and tissue donor, check box to consent to organ and tissue donation.

YES

By checking “yes” above, you are consenting to organ and tissue donation. Your consent to be an organ and tissue donor will then be clearly indicated on the front of your identification card with a small red heart. For additional information on organ and tissue donation, you may contact the Maine Transplant Program (207-871- 2000), the National Kidney Foundation of Maine (207-772-7270) or New England Donor Bank (1-800-446- 6362) or visit our website at www.maine.gov/sos/bmv/organ.htm It is important to discuss your decision with your family.

Social Security Number Disclosure Statement

This statement is made in accordance with the Federal Privacy Act of 1974, Section 7(b). Disclosure of your social security number is required by 29-A MRSA §1301(5) and (6) to apply for or renew a driver’s license or

non-driver identification card. Your social security number will be used solely for identification purposes and will be kept confidential.

“I understand that knowingly supplying false information on this form is a Class D crime under Title 17-A, punishable by confinement of up to 364 days or monetary fine of up to $2000.00 or both”

__________________________________________________________________________

_____________________________________

Signature in ink

Date

See reverse for acceptable identification documents

MV-16 Rev 07/2011

Two (2) of the following documents are required for identification

One must indicate your date of birth and the other must bear your written signature. If you are the holder of a driver’s license from any state or province, that license must also be produced. Photocopies

are not accepted.

____ Adoption Record

____ Draft Card

____ Parent/Guardian**

____ Baptismal Record

____ Driver’s License

____ Passport

____ Birth Certificate

____ Driver’s Permit

____ Permanent Resident Card

____ Certificate of Marriage

____ Employment Authorization Card

____ Resident Alien Card

____ Citizenship Document

____ Machine Readable Visa

____ School Record/Transcript

 

 

(Certified)

____ Concealed Weapon Permit

____ Medical Record/Hospital Record

____ Social Security Card

____ Copy of Marital Application

____ Military Dependent I.D. Card

 

____ Court Document

____ Military Discharge (DD-214)

 

____ Divorce Papers

____ Military I.D. Card

 

**Parent or Guardian must appear in person and prove identity. This option applies only to minors.

NOTE: In addition to an original birth certificate, a certified copy of a birth certificate is acceptable. A document is certified if it has an embossed seal or stamp of the issuing agency. A photocopy of a certified copy of a birth certificate or an original birth certificate is NOT acceptable.

_________________________________________________________________

Issuing Official

Bureau of Motor Vehicles License Information

101 Hospital Street, 29 State House Station, Augusta, ME 04333-0029

207 624-9000 Extension 52114

TTY Users call Maine relay 711

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MV-16 conclusion process described (part 1)

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