Signatures must be originals. Photocopies are not acceptable. Changes may not be made to this form once it is signed.
Certification: I hereby certify under penalty of perjury that all statements in this application are true and correct.
Misstatement: any misstatement of material facts may cause cancellation and/or denial of my driver's license, instruction permit or identification card.
Cards listed: Non-Commercial Driver's License, Driver Authorization Card, Instruction Permit, Identification Card.
| Question | Answer |
|---|---|
| Form Name | DMV-128 |
| Form Length | 1 page |
| Fillable? | Yes |
| Fillable fields | 16 |
| Avg. time to fill out | 3 min |
| Edition | 9/2026 |
| Matches the agency's file | Yes, checked October 4, 2026 |
| Other names | DMV-128, DMV 128, DMV128, Declaration of Homeless Status |
| Official source | DMV-128 (Rev 9/2026), |
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