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):
NYS license in exchange for a license from another
US State, the District of Columbia or Canadian Province
Check this box if you would like to have “Veteran” printed on the front of your photo document.
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?
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.
NEW YORK STATE ORGAN AND TISSUE DONATION
(You must fill out the following section)
Check this box to make a $1
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.
and educational projects promoting
You must answer the following question: Would you like to be added to the Donate Life Registry?
Skip This Question
organ and tissue donation.
Donor Consent Signature:
Do you now have, or did you ever have a New York:
NYS DRIVER LICENSE, LEARNER PERMIT, or
NON-DRIVER ID CARD NUMBER
Driver license? . . . . .
If “Yes”, enter the identification number as it appears
Learner permit? . . . .
on the license, learner permit, or non-driver ID card.
Non-driver ID Card?
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
FULL FIRST NAME
District of Columbia or a Canadian Province?
If “Yes”, where was it issued? ____________________________
Date of Expiration: Type of License:
License ID No.:
FULL MIDDLE NAME
DAY PHONE NO. (Optional)
DATE OF BIRTH
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
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)
City or Town
ADDRESS WHERE YOU LIVE
IF DIFFERENT FROM MAILING ADDRESS - DO NOT GIVE P.O. BOX.
City or Town
Has your mailing address changed?
Has your name changed?
Has the address where you live changed?
If “Yes”, print your former name exactly as it
What is the change and the reason for it
appears on your present license or non-driver ID card.
(new license class, wrong date of birth, etc.)?
PLEASE COMPLETE AND SIGN PAGE 2
Failed to answer summons
Social Security Card
Medical Certificate (CDL Only)
License/Permit Surrendered for Non-Driver ID Card