OFFICIAL: Sensitive – Personal
(when completed)
3 Licence and registration changes
Signature
1
Customer details (include all NEW details)
Surname
Given name(s)
Residential address or business address
(licence address must be in NSW)
Mailing address
Postcode
Vehicle garage address (where the vehicle will most often be kept)
Postcode
Postcode
Your licence or customer number
You declare that the information on this form is true and complete.
Under the road transport legislation it is an offence for anyone to attempt
to obtain or renew a driver licence, or to register or renew the
registration of a vehicle, by false statement or other dishonest means.
Declaration
Change of Records – Road and Maritime Products
Changes to address, name, licence, vehicle, vessel, engine details, contact details
Office-Use
Attachments
Please provide your email address if you would like to
register for an online service account. Go to service.nsw.
gov.au/online-services for more information.
4
Date
day month year
Email address
/ /
Page 1 of 2
Please provide a mobile number if you would like to receive
communications from Service NSW this way.
Mobile number
(continued next page)
Catalogue No. 45070212, Form No. 1021 (9/2021)
ABN 18 804 239 602
Fleet manager name (if applicable)
Contact person name
Organisation name (if applicable)
Products held (tick and complete all applicable)
What driver licence details are to be changed?
(Permanent residency status may be verified online by Transport for
NSW with the Department of Home Affairs. For a full list of acceptable
proof of Australian residency documents, see our website at roads-
waterways.transport.nsw.gov.au)
Driver licence or customer
number
Boat or Mooring licence
number
Combined licence - driver/boat driving
Vehicle plate number
Vessel registration number
What vehicle registration details are to be changed?
What boat or mooring licence details are to be changed?
What vessel registration details are to be changed?
2 Personal details
Date of birth
Gender
Male Female
day month year
/ /
C
Use this form to make changes to your NSW driver licence (all classes), boat licence, combined licence, NSW photo card, vehicle or vessel
registration, and/or mooring licence.
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 visit any service centre to make changes.
Combined licence holders and customers with both road and maritime products should attend a service centre that conducts
maritime business.
.
For further enquiries visit a service centre or call Service NSW on 13 22 13
.
Hearing or speech impaired? Call us on the National Relay Service: TTY users phone 13 36 77 then ask for 13 22 13.
Speak and Listen users phone 1300 555 727 and ask for 13 22 13
Transport for NSW no longer record organ donation details. For more information visit donatelife.gov.au.
.
No Yes
(If different from residential address
All mail will be posted to this address)
Personal Information Collection Notice
Transport for NSW is committed to protecting your privacy and ensuring
your personal and health information is managed according to law.
Find out why we collect your personal information and how we
use and manage it by reading our privacy statement at
www.transport.nsw.gov.au/privacy-statement or phone 13 22 13 to
request a copy.
Print name and Capacity (if representing an organisation)
