Form Mv-44 - Application For Driver License Or Non-Driver Id Card
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3MV-44 (8/13)
New York State Department of Motor Vehicles
APPLICATION FOR DRIVER LICENSE OR NON-DRIVER ID CARD
PLEASE PRINT CLEARLY IN BLUE OR BLACK INK.
This form is also available on DMV’s web site at:
If you are interested in applying for an Enhanced Driver License or Non-driver Identification Card (EDL/ID),
or upgrading your current NYS document to an EDL/ID please see forms MV-44EDL and MV-44.1EDL.
I AM APPLYING FOR A
(check any that apply):
o
o
o
o
o
o
NYS license in exchange for a license from another
Learner Permit
ID card
Change
Renewal
Replacement
US State, the District of Columbia or Canadian Province
o
Check this box if you would like to have “Veteran” printed on the front of your photo document.
VETERAN STATUS
You must present proof that indicates an honorable discharge from military service. For additional information, please see form MV-44.1.
NOTE: If you do not check either box, you will be considered to have decided not to register to vote.
VOTER REGISTRATION QUESTIONS
(Please answer “yes” or “no”.)
If you are not registered to vote where you live now, would you like to apply to register, or if you are changing your address, would you like the Board of Elections to be notified?
o
o
YES - Complete Voter Registration Application Section (Not necessary
NO - I Decline to Register/Already Registered/I do not want to notify
if you will be applying in person at a DMV office).
the Board of Elections of my change of address.
o
NEW YORK STATE ORGAN AND TISSUE DONATION
(You must fill out the following section)
Check this box to make a $1
SM
To enroll in the NYS Department of Health’s Donate Life Registry, check the “yes” box and then sign and date below. You are
voluntary contribution to the Life...Pass
certifying that you are: 18 years or older; consenting to donate all of your organs and tissues for transplantation, research or both;
It On Trust Fund. The $1 donation will
authorizing DMV to transfer your name and identifying information to DOH for enrollment in the Registry; and authorizing DOH to allow
be added to your total transaction fee. A
access to this information to federally regulated organ donation organizations and NYS-licensed tissue and eye banks and hospitals,
contribution to the Fund is used for
upon your death. “ORGAN DONOR” will be printed on the front of your DMV photo document. You will receive a confirmation from
organ donation and transplant research
DOH, which will also provide you an opportunity to limit your donation.
o
o
and educational projects promoting
You must answer the following question: Would you like to be added to the Donate Life Registry?
Yes
Skip This Question
♥
ç
organ and tissue donation.
Donor Consent Signature:
Date:__________________
____________________________________________________
IDENTIFICATION INFORMATION
Do you now have, or did you ever have a New York:
NYS DRIVER LICENSE, LEARNER PERMIT, or
o
o
NON-DRIVER ID CARD NUMBER
Driver license? . . . . .
Yes
No
If “Yes”, enter the identification number as it appears
o
o
Learner permit? . . . .
Yes
No
¦
on the license, learner permit, or non-driver ID card.
o
o
Non-driver ID Card?
Yes
No
FULL LAST NAME
Do you have or did you ever have a driver license that is valid or
that expired within the past year, issued by another US State, the
o
o
FULL FIRST NAME
District of Columbia or a Canadian Province?
Yes
No
If “Yes”, where was it issued? ____________________________
Date of Expiration: Type of License:
License ID No.:
FULL MIDDLE NAME
DAY PHONE NO. (Optional)
SUFFIX
DATE OF BIRTH
SEX
HEIGHT
EYE COLOR
Male
Female
Area Code
Month
Day
Year
Feet
Inches
o
o
(
)
*
*
You must provide your SSN. Authority to collect your SSN is granted by Sections 490.3 and 502 of the Vehicle and Traffic Law.
SOCIAL SECURITY NUMBER
(SSN)
The information will be used only for exchange with other jurisdictions, to assist in verification
of identity, and to invoke driver license sanctions pursuant to V&T Law Section 510(4-e). Your
number will not be given to the public, or appear on any form or information request.
ADDRESS WHERE YOU GET YOUR MAIL
- Include Street Number and Name, Rural Delivery and/or box number (If PO Box, also fill in “Address Where You Live” below)
Apt. No.
City or Town
State
Zip Code
County
ADDRESS WHERE YOU LIVE
IF DIFFERENT FROM MAILING ADDRESS - DO NOT GIVE P.O. BOX.
Apt. No.
City or Town
State
Zip Code
County
o
o
o
o
Has your mailing address changed?
Has your name changed?
Yes
No
Has the address where you live changed?
Yes
No
o
o
If “Yes”, print your former name exactly as it
Yes
No
What is the change and the reason for it
OTHER CHANGE:
appears on your present license or non-driver ID card.
(new license class, wrong date of birth, etc.)?
PLEASE COMPLETE AND SIGN PAGE 2
.
Other
F
License
A
B
C
NCDL-C
D
DJ
Restrictions
O
Class
E
ID
M
MJ
R
Endorsements
AM
PP
DP
LR
PI
LS
BC
Special
O
Conditions
Vehicle
ML
NF
UC
UP
UR
X8
XT
F
Restrictions
F
o
o
o
STOP/RESPONSE
Approved By
Date
Proof Submitted:
I
Birth Certificate
Driver License/ID
MV-45
o
o
o
o
o
o
C
Passport
Learner Permit
INS Papers
Credit Card
Failed to answer summons
TEENS
E
o
o
o
o
Image Retrieval
Social Security Card
Medical Certificate (CDL Only)
Office
Insurance lapse
U
Other:
S
o
E
License/Permit Surrendered for Non-Driver ID Card
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