New York Dmv Form – Fill Out and Use This PDF

MV-45 (9/12)

NewYorkStateDepartmentofMotorVehicles

STATEMENT OF IDENTITYAND/OR RESIDENCE BYPARENT/GUARDIAN

www.dmv.ny.gov

Usethisformifyouareunderage21andcannotprovideenoughproofsfromoneorbothofthefollowing:

➤“ProofofName”listonformID-44orID-82(ProofsofIdentity);

➤“ProofofResidence”listonformID-44EDL(ProofsofIdentity,CitizenshipandResidence).Oneadditional proofofresidencethatisinthenameofthepersonwhoisunderage21orinthenameoftheparentorthe guardianmustbesubmittedwiththisstatement.

NOTE: Proof of residence is required only with applications for an enhanced document.

Yourparentorguardiancanverifyyouridentity,orresidence,orbothbyfollowingthesesteps:

➤YoumustbringyourparentorguardianwithyoutotheMotorVehiclesofficewhenyouusethisform.

➤YourparentorguardianmustcompletetheinformationbelowwithaMotorVehiclesRepresentativepresent.

➤Youmustpresentproofofyourdateofbirthwiththisform.Ifyouapplyforalicense,permit,ora non-driveridentificationcard,youmustalsomeettheSocialSecuritycardrequirementonformID-44.

➤Documentationmustbesubmittedtoprovetheidentityofyourparentorguardian.Yourparentorguardianmust provideavalidNewYorkStatedriverlicense,alearnerpermitoranon-driveridentificationcardormeettheproofof identityrequirementsonformID-44.

➤IMPORTANT: DO NOT SIGN THIS FORM UNTILYOUARE WITHAMOTOR VEHICLES REPRESENTATIVE.

CERTIFICATION

I, ___________________________________________________________________, certify as the parent/legal

(Name of Parent/Guardian)

guardian of_____________________________________________________________________, who resides at

(Name ofApplicant)

__________________________________________________________________________________________

(Address)

that this name is the name by which (s)he is commonly known and that (s)he resides at the address above.To the best of my knowledge, (s)he has not obtained or applied for a learner permit, non-driver identification card, or driver license in any other name. I understand that any false statement I have made on this certification is a misdemeanorunderSection392oftheVehicleandTrafficLaw.

Parent/GuardianSignHereç____________________________________________________________

Parent/GuardianPrintNameHere: ______________________________________________________________

IdentificationNo.fromDriverLicense,LearnerPermitorNon-DriverIDCard: __________________________

PrintYour

MailingAddress: ____________________________________________________________________________________

____________________________________________________________________________________

IMPORTANT: DO NOT SIGNTHIS FORM UNTILYOUARE WITHAMOTORVEHICLES REPRESENTATIVE.

Other: ____________________________________________________________________________________________

Signature of PersonAccepting Proof ç ____________________________________________________________

Title of PersonAccepting Proof: ________________________________________________ Date ____________