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APPLICATION FOR CHANGE OF ADDRESS ON …

No Waiting in Line! – Change your address online Visit our Web site at www.texas.gov/driver I do solemnly swear, affirm, or certify that I am the person named herein and that the statements on this application are true and

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Text of APPLICATION FOR CHANGE OF ADDRESS ON …

Driver License Number Expiration DateSocial Security Card NumberDate of BirthSuffix (SR., JR., etc.)Last NameFirst NameMiddle / MaidenResidence- Street Address (Address cannot be a post office box)CityCountyState Zip CodeMailing- Street Address CityCountyState Zip CodeM MSee Important Instructions on BackAPPLICATION FOR CHANGE OF ADDRESS ON VALID TEXASDRIVER LICENSE (DL) & IDENTIFICATION CARD (ID)Not For Commercial Driver License*642008*DO NOT MAIL check or money order payable to:Texas Department of Public SafetyMAIL COMPLETED FORM AND $10 FEE TO:Texas Department of Public Safety, PO Box 149008, Austin, Texas, 78714-9008Date Signature DL-64 (Rev. 2/17)D DY Y Y YM MD DY Y Y YDo you want to support theGlenda Dawson DonateLife Texas donor registry?If yes, please indicate adonation amount of $1 ormore $ No ccIf you are a US citizen,would you like to register tovote? If registered, wouldyou like to update yourvoter information?Yes No ccWould you like to registeras an organ donor?Yes No ccNo Waiting in Line! Change your address onlineVisit our Web site at do solemnly swear, affirm, or certify that I am the person named herein and that the statements on this application are true andcorrect. I further certify my residence address is a: (check one) ( ) single family dwelling, ( ) apartment, ( ) motel,( ) temporary shelter. Signature of ApplicantDateIn the event of injury or death would you like to provide two (2) emergency contacts? If yes, please list:a)Name Address Telephone Number b)Name Address Telephone Number If you currently hold a valid Texas non-commercial driver license or identification card and have not reported yourchange ofaddress as required by TRC , you may do so by mail or on the Internet. To report a change of addressby mail, com-plete the reverse side of this form and mail along with the required fee(s) to the Texas Department of Public Safety. To report achange of address online, go to A driver license or identification card validating your reportedaddresschange will be mailed to you. This formmay ONLYbe used to change your you desire a new photo or need to change information other than youraddress, you must apply at the local driver license you are not a US citizen you must apply at the local driver license office to change your States Selective ServiceAny male United States citizen or immigrant who is at least 18 years of age but less than 26 years of age submitting this applicationconsents to registration with the United States Selective Service System. You must be registered to qualify for federal student aid(to include Pell grant), job training, federal employment, and citizenship if an immigrant. In Texas, you must be registered to qualifyfor state college student aid or state employment. If convicted, failure to register with the Selective Service is a felony punishableby up to five years in prison and/or a $250,000 fine. If not registered by age 26, you can no longer register and could permanentlylose those benefits associated with registration. For alternative options for applicants who object to conventional military servicefor religious or other conscientious reasons information is available at: is an example of how numbers and letters should be written on front of this form:1234567890ABCDEFGHIJKLMNOPQRSTUVWXY Z

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