The Pull Notice form, administered by the State of California Department of Motor Vehicles (DMV), is an essential document for businesses and organizations that employ drivers. Its primary function is to allow employers to monitor the driving records of their employees to ensure safety and compliance with driving regulations. This form, a part of the Employer Pull Notice Program, helps in the proactive management of risks associated with operating vehicles for business purposes. By submitting a Pull Notice form, businesses can amend account information or report changes in company details, such as a change in ownership, contact person, mailing address, or email. The prompt submission of this form, within 10 days of any change, is crucial for maintaining up-to-date records with the DMV. This process not only aids in the lawful conduct of business by ensuring all driving records are current but also emphasizes the organization's commitment to road safety. Furthermore, the form serves as a declaration under the penalty of perjury under California law, underscoring the accuracy and truthfulness of the information provided by the authorized person completing it. By participating in this program and correctly utilizing the Pull Notice form, businesses safeguard their operations and contribute to a safer driving environment for all.
| Question | Answer |
|---|---|
| Form Name | Pull Notice Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | pull notice, form employer pull notice, how to dmv pull notice, california dmv pull notice |
STATE OF CALIFORNIA
DEPARTMENT OF MOTOR VEHICLES®
A Public Service Agency
INFORMATION SERVICES BRANCH
EMPLOYER PULL NOTICE
CHANGE OF ACCOUNT INFORMATION
SUBMIT WITHIN 10 DAYS OF CHANGE
SECTION A — CURRENT INFORMATION ON FILE
COMPANY NAME
DBA
MAILING ADDRESS
REQUESTER CODE NUMBER
TELEPHONE NUMBER
( )
CONTACT PERSON
ATTENTION (MAIL TO)
EMAIL ADDRESS
SECTION B — REQUESTED CHANGES TO THE EMPLOYER PULL NOTICE ACCOUNT
IF YOUR BUSINESS IS UNDER NEW OWNERSHIP, A NEW APPLICATION IS REQUIRED. CALL FOR ADDITIONAL INFORMATION.
EMAIL ADDRESS
MAILING ADDRESS
CONTACT PERSON
TELEPHONE NUMBER
( )
ATTENTION (MAIL TO)
I understand that this information is provided for the lawful conduct of this business and the pursuit of its interest and that any misuse will result in both cancellation of the requester number and refusal of subsequent application for requester number.
I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
AUTHORIZED PERSON’S SIGNATURE
X
Return completed form to: DEPARTMENT OF MOTOR VEHICLES Employer Pull Notice Unit
P. O. Box 944231
Mail Station
“Upon request, this document can be produced in Braille or large print.”
INF 4 (REV. 6/2011) WWW