THE PERSON SIGNING THIS FORM MUST READ THESE INSTRUCTIONS CAREFULLY:
1. If the applicant is a citizen of the United States then check the box to the left of the statement, “The applicant is a citizen of the
United States.” If the person signing this form is not a citizen of the United States then the person should check the box to the left of
the statement, “The applicant is an approved alien under the Federal Immigration and Nationality Act and is approved to be present
in the United States.”
2.
document in the space provided after “Authorizing Document.” For example, INS Form 1-551 or INS Form 1-94. See page 2 for
3.
4.
APPLICANT INFORMATION
(Choose one) NEW APPLICATION RENEWAL APPLICATION
(if applying for renewal)
First Name Middle Name Last Name
Current Physical Street Address City State Zip
ATTACH A COPY OF THE FRONT AND BACK OF YOUR AUTHORIZING DOCUMENT IF APPLICABLE.
Name of Authorizing Document Attached
(Choose one)
THE APPLICANT IS A CITIZEN OF THE UNITED STATES
THE APPLICANT IS AN APPROVED ALIEN UNDER THE FEDERAL IMMIGRATION AND NATIONALITY ACT
AND A APPROVED TO BE PRESENT IN THE UNITED STATES.
PLEASE PRINT OR TYPE CLEARLY
Signature: Date:
Updated 6.14.2022
Oklahoma.gov/OMMA
Page 1 of 2
Website: Oklahoma.gov/OMMA | (405)522-OMMA
AFFIDAVIT OF LAWFUL PRESENCE
BY PERSON MAKING APPLICATION FOR A LICENSE
Alien Lawfully Admitted for Permanent Residence:
Immigrant or Non-Immigrant Visa Status:
INS Form I-94
Asylee:
Refugee:
INS petition and appropriate supporting documentation.
Alien Paroled Into the U.S. for a least One Year:
aggregateperiods of admission for less than one year to meet
Alien Whose Deportation or Removal Was Withheld:
Alien Granted Conditional Entry:
annotated “A3”.
Cuban/Haitian Entrant:
Unexpired temporary I-551 stamp in foreign passport or on
QUALIFIED ALIENS MUST ATTACH A COPY (FRONT & BACK) OF THE DOCUMENTS
QUALIFIED ALIENS
Updated 6.14.2022Oklahoma.gov/OMMA Page 2 of 2
VALID DOCUMENTARY EVIDENCE
OF LAWFUL PRESENCE
DISPENSARY • GROWER • PROCESSOR
TRANSPORTER • WASTE • LABORATORY