Commercial Driver License Mail Renewal Application
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Complete Commercial Driver License Mail Renewal Application with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
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1
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3Renewal of Commercial
Primary ID __________________________
Secondary ID __________________________
Driver License By Mail
C – K – M # ___________
Amount $ ___________
Page 1 of 3
Date____________ Initials ___________
ATTN: Mail-In DL P.O. Box 201430 Helena, MT 59620-1430 Phone (406) 444-1352 Fax (406) 444-3916
You must use BLACK ink to complete this form
st
Legal Last Name
Legal First Name
Legal Middle Name
Suffix (Jr., Sr., 1
, etc.)
Date of Birth (mm/dd/yyyy) Sex
Eye Color
Weight
Height
Hair Color
Are you a Montana Resident? County #
Female
Yes
No
Male
Montana Residential Address
City
State Zip Code
MT
Montana Mailing Address
City
State
Zip Code
MT
Address where your paper and hard copy driver license should be
City
State Zip Code
sent (cannot mail out of country)
Place of Birth: City
Place of Birth: State/Province/Country
Are you a
Yes
United States
If “No” STOP. You must renew in person.
No
Citizen?
Montana Driver License Number
Social Security Number
Email Address
Current Daytime Phone Number
REGISTER OR UPDATE VOTER REGISTRATION INFORMATION
You can visit the Montana Secretary of State “My Voter Page” to check if you are registered to vote, check your voter registration address,
and find the location and directions to your polling place at: https://app.mt.gov/voterinfo/.
Your decision to register to vote or not, and where you submitted this form, will remain confidential.
Do you want to register to vote in Montana or update your voter registration? Yes No
If “No” stop and complete page 2. If “Yes” continue on.
County you are registering to vote in:______________________________________________
Check all that apply: New Registration
Name Change
Address Change
Yes
No
Are you a citizen of the United States?*
Yes
No
Will you be at least 18 years of age on or before the next election?*
Yes
No
Will you be a Montana resident for at least 30 days before the next election?*
No
If you checked “
” in response to any of these questions stop and go to page 2.
Previous Registration Information – will be used to provide cancellation information to former jurisdiction. Required if name changed
or if previously registered to vote in another MT county or in another state.
Previous Registration Name
Residence Address of Previous Registration
Previous City
Previous County
Previous State
Previous Zip
Voter Applicant Affirmation
I affirm under penalty of perjury that the information on this application is true, that I am a citizen of the United States, that I will be at
least 18 years old on or before the next election, that I will have been a resident of Montana for at least 30 days prior to the next
election, and that I am not serving a felony conviction in a penal institution nor have been found to be of unsound mind by a court. I
understand that if I have given false information on this application, I may be subject to a fine or imprisonment, or both, under federal
and/or state law. By signing you authorize the Motor Vehicle Division to use your electronic signature for voter registration purposes.
Signature*
Date*
*The affirmation on this application for voter registration must be signed by the applicant. Failure to do so will prevent application
from being processed.
21-199A-CDL (3/16)
Page 1 of 3
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