Driver and Vehicle Services
Customer Services Contact Form
Questions
To better assist us with your question, please complete the following information:
Customer Information
First Name
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First name is required
Last Name
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Last name is required
Middle Name/Initial
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Middle initial is required
Date of Birth
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( mm/dd/yyyy format )
Date of birth is required
Invalid date ( mm/dd/yyyy )
E-mail Address
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Email address is required
Invalid Email Address
Daytime Phone Number
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Phone number is required
Invalid Phone number
Registration Street Address
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Address is required
Address Line 2
( Apt, Suite, Unit, etc. )
City
*
City is required
State
*
*
Zip Code
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Zip Code is required
Invalid zip code
Information
DL/ID Number or Letter ID
Question
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