Form No. 1021 - Change Of Records - Roads & Maritime Products
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1
2Change of Records – Roads & Maritime Products
C
Changes to address, name, licence, vehicle, vessel, engine details, contact details
Use this form to make changes to your NSW driver licence (all classes), boat licence, combined licence, NSW photo card, vehicle or vessel
Office-Use
.
registration, and/or mooring licence.
Attachments
You must provide original copies of supporting documents. (Photocopies will not be accepted)
.
Customers with road products only (ie a driver licence and vehicle registration) can attend any service centre to make changes.
Combined licence holders and customers with both road and maritime products should attend a service centre or registry that
conducts maritime business.
.
For further enquiries contact a service centre or call Service NSW on 13 77 88
Hearing or speech impaired? Call us on the National relay Service: TTY users phone 13 36 77 then ask for 13 77 88.
Speak and Listen users phone 1300 555 727 and ask for 13 77 88
.
Roads and Maritime Services no longer record organ donation details. For more information visit donatelife.gov.au.
Products held (tick and complete all applicable)
2
Personal details
Date of birth
Driver licence or customer
Boat or Mooring licence
Gender
number
number
Male
Female
/
/
day
month
year
3
Licence and registration changes
Combined licence - driver/boat driving
Your licence or customer number
No
Yes
Vehicle plate number
What driver licence details are to be changed?
(Permanent residency status may be verified online by Roads and
Maritime with the Department of Immigration and Border Protection. For
a full list of acceptable proof of Australian residency documents, see our
Vessel registration number
website at rms.nsw.gov.au)
1
Customer details (include all NEW details)
Surname
What vehicle registration details are to be changed?
Given name(s)
What boat or mooring licence details are to be changed?
Organisation name (if applicable)
Residential address or business address (licence address
What vessel registration details are to be changed?
must be in NSW)
Postcode
Mailing address
4
Privacy Statement and Declaration
(If different from residential address
All mail will be posted to this address)
Roads and Maritime is collecting your personal information to change
your details on our records and may retain and use it for driver licensing,
motor vehicle and road transport or safety purposes.
Under road transport legislation you are required to notify us if you
Postcode
change your name or address or garaging address of your vehicle.
We may disclose your personal information: to other driver licensing and
Vehicle garage address (where the vehicle will most often be kept)
vehicle registration agencies, to assess your application or verify the
information you provide and for inquiries about motor accidents.
Additionally, where you provide personal information concerning the
registration of a vehicle we may disclose that: to confirm any compulsory
Postcode
third party (bodily injury) insurance is current, to anyone proposing to
acquire an interest in your vehicle, in respect of inquiries relating to stolen or
Please provide your email address if you would like to
abandoned vehicles, and to any joint registered operator of your vehicle.
register for an online service account. Go to service.nsw.
Otherwise we will not disclose your personal information without your
gov.au/online-services for more information
consent unless authorised by law.
Email address
Your personal information will be held by us. You have the right to access
and correct the information if you believe that it is incorrect. You can contact
us to request to access or correct it.
You declare that the information on this form is true and complete.
Please provide a mobile number if you would like to receive
Under the road transport legislation it is an offence for anyone to attempt
communications from Service NSW this way
to obtain or renew a driver licence, or to register or renew the
Mobile number
registration of a vehicle, by false statement or other dishonest means.
Name
Contact person name
Date
Fleet manager name (if applicable)
/
/
(continued next page)
day
month
year
Catalogue No. 45070212, Form No. 1021 (05/2016) ABN 76 236 371 088
Page 1 of 2
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