Form Vr-154i - Application For Maryland Challenge Of Address And/or Name (Page 2 of 2) in pdf

Instructions - Once you have completed this form, please forward to the address on the front of this form or bring it into any Motor

Vehicle Administration (MVA) full service office. The Maryland Motor Vehicle Law requires that you notify the MVA of any change in

your address or in your name within thirty (30) days of the change.

1. On the top left-hand portion of the reverse side, copy all information directly from your present driver’s license (be sure to include your

driver’s license number). If you do not have a Maryland driver’s license and only want to change your name and/or address on vehicle title

and registration documents, simply print your full name and date of birth in the spaces provided.

2. On the top right-hand portion of the reverse side, print only the information you want changed. Print your new name or new address,

etc. Be sure to check the reason if you change your name.

3. Names may be changed in several ways in order to comply with the vehicle laws. If a name is changed through marriage or divorce, a

copy of the marriage certificate or divorce decree is required. An individual may reassume a name previously used, provided the name

is used openly, consistently, and without fraudulent intent. To assume your birth name, or other former name, which cannot be verified

from our records, you must submit a copy of your birth certificate, marriage certificate and one other form of identification, such as a

social security card, a voter’s registration card or a bank statement. Please complete affidavit on the reverse side.

4. A change of name may also be accomplished by a court order. Please consult your attorney.

5. If parties to a marriage assume the other spouse’s surname in conjunction with their own, the MVA will accept hyphenated surnames.

The complete name, including spaces, may not exceed thirty characters.

6. A change of name by common law refers to a name that an individual has assumed and uses openly, consistently, and without fraudu-

lent intent. To assume a name under the common law of this state, you must submit a copy of your birth certificate and any driver’s

license issued in the name previously used before. You must also submit in your common law name, your original social security card

(or social security records) and at least two (2) documents from the following categories: tax records, selective service card or

records, voter registration card or records, passport, government photo I.D., baptismal certificate, banking records, or other proof of

age and identity that is satisfactory to the MVA.

7. If you are leasing a vehicle, please complete another Change of Name/Address form using the owner and vehicle information from

the leased vehicle’s registration card.

A commercial driver must obtain a corrected license whenever the commercial driver changes his name or her name and/or mailing

address.

(

TO REGISTER YOU MUST

PARTY AFFILIATION

ITEM

• Be a U.S. citizen;

You must register with a party if you want to take part in that party's

primary election.

• Be a Maryland resident;

• Be at least 18 years old or older by the next General Election;

DEADLINE INFORMATION

• Not be under guardianship for mental disability;

• This application must be received by a Maryland election office no

• Not have been convicted of buying or selling votes;

later than 9 p.m. 21 days before an election.

• Not have been convicted of a felony, or if I have, I have

• If your application is complete and you are found to be

completed serving a court-ordered sentence of imprisonment,

qualified, a Voter Notification Card will be mailed to you.

including any term of parole or probation for the conviction.

• You are not registered until you receive your Voter Notification

Card.

USE VOTER REGISTRATION APPLICATION IN SECTION B TO

• The submission of this form to an individual other than an

• Register to vote in federal, state, county, and municipal elections

official, employee, or agent of a County Board of Elections does

in Maryland.

not assure that the form will be submitted or filed in a timely

• Change your name, address, or party affiliation.

manner.

(

SOCIAL SECURITY NUMBER

ITEM

WARNING

The disclosure of your full social security number is voluntary. The

Giving false information to obtain voter registration is perjury and

statutory authority allowing officials to request your social security

is punishable by a fine of up to $1000, or imprisonment for up to 5

number is Election Law Art., §3-202. The number will only be used

years, or both.

for registration and other administrative purposes. It will be kept

confidential.

* Remember: You are not a registered voter until you receive your Voter Notification Card in the mail. If you do not receive your

Voter Notification Card in three weeks, you should contact the State Board of Elections at 1-800-222-VOTE (8683).

CR CC

Apply to register to vote with your driver’s license transaction. For details ask your customer service representative.

White Copy - Board of Elections

Canary Copy - MVA

Pink Copy - Customer

Form Vr-154i - Application For Maryland Challenge Of Address And/or Name Page 2

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