OFFICIAL: Sensitive – Personal
(when completed)
3 Licence and registration changes
Customer details (include all NEW details)
Given name(s)
Residential address or business address
(licence address must be in NSW)
Mailing address
Vehicle garage address (where the vehicle will most often be kept)
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.
Change of RecordsRoad and Maritime Products
Changes to address, name, licence, vehicle, vessel, engine details, contact details
Please provide your email address if you would like to
register for an online service account. Go to service.nsw. for more information.
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-
Driver licence or customer
Boat or Mooring licence
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
Male Female
day month year
/ /
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
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 or phone 13 22 13 to
request a copy.
Print name and Capacity (if representing an organisation)
OFFICIAL: Sensitive – Personal
(when completed)
Effective date
Conditions / Endorsements
Condition code
Customer service representative's signature
DateStaff number
day month year
day month year
Engine make
Motive power
Examiner's signature
Registration plate number
Engine number
Inspection report number
Authorised Examiner's use
Note: Identification numbers must be completed below,
when an examination of the vehicle required the vehicle
details to be changed.
VIN or chassis/frame number - ensure all characters are recorded
No. cylinders or rotors
Engine capacity
Gross combination mass
Overall axle spaceGross vehicle mass
Axle code WheelbaseTare weight
Vehicle fittings
Other (specify changes)
Station name, address and number
Name Authorised examiner
I certify I have examined the vehicle and the changed
detail/s comply in all respects with the Rules for
Authorised Inspection Stations.
Examiner's number
day month year
Representative's Authority
(Changes to organisation and vehicle details only)
This section must be completed if you send someone else to
conduct business on your behalf
I declare that the person below is my authorised representative
day month year
/ /
Representative's details
Date of birth
day month year
/ /
Male Female
Representative's signature
day month year
/ /
NSW Driver Licence / Customer number
Page 2 of 2
Catalogue No. 45070212, Form No. 1021 (9/2021)
ABN 18 804 239 602
Nominated Configuration Code
Document produced to prove change
Stand alone or primary proof
SNSW Office Use - BUNDLE C
Proof of Identity Record
Secondary proof (if necessary)
Document number
Secondary proof Issue or E/Date
Date of issue or expiry date
SNSW location
Issue centre number
day month year
Mailing address checked on DRIVES (if applicable)
Print name and Capacity (if representing an organisation)