Fillable INDIVIDUAL RESTORATION REQUIREMENT APPLICATION (The State of New Jersey)

Fill Online, Printable, Fillable, Blank INDIVIDUAL RESTORATION REQUIREMENT APPLICATION (The State of New Jersey) Form

Use Fill to complete blank online THE STATE OF NEW JERSEY pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

INDIVIDUAL RESTORATION REQUIREMENT APPLICATION (The State of New Jersey)

On average this form takes 2 minutes to complete

The INDIVIDUAL RESTORATION REQUIREMENT APPLICATION (The State of New Jersey) form is 1 page long and contains:

  • 0 signatures
  • 0 check-boxes
  • 7 other fields

Country of origin: US
File type: PDF

Use our library of forms to quickly fill and sign your The State of New Jersey forms online.

BROWSE THE STATE OF NEW JERSEY FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
DRM-21 (06/19)
For MVC Request Processed as of: Clerk ID: Reason for Rejection:
Use Only
INDIVIDUAL RESTORATION REQUIREMENT APPLICATION
This application is required for individuals seeking information regarding the requirements to restore their driving and/or
registration privileges. Requests on behalf of clients must be submitted on application number DRM-21A in conformance
with its instructions. These forms can be acquired from the Motor Vehicle Commission (MVC) website at www.njmvc.gov
.
There is no fee for this service. This application may be photocopied for your convenience and it may be mailed, faxed or
emailed to the Motor Vehicle Commission. Please allow 10 business days to process the application.
ALL SECTIONS OF THIS APPLICATION MUST BE COMPLETED TO OBTAIN RESTORATION REQUIREMENT INFORMATION
(PLEASE PRINT CLEARLY)
REQUESTER’S NAME (First, MI, Last)
PHONE NUMBER
STREET ADDRESS
CITY, STATE & ZIP CODE
*REQUESTER’S EMAIL ADDRESS (if applicable)
REQUESTER’S DRIVER LICENSE NUMBER
NOTE: THE APPLICATION MUST BE ACCOMPANIED BY A
PHOTOCOPY OF THE REQUESTER’S CURRENT DRIVER
LICENSE OR NON-
DRIVER IDENTIFICATION CARD. IF
NEITHER OF THESE DOCUMENTS ARE AVAILABLE, PLEASE
CONTACT THE DRIVER RECORDS MANAGEMENT BUREAU
AT THE NUMBER LISTED ABOVE FOR ASSISTANCE.
For Official Use Only
I certify that all the foregoing statements made by me are true. I understand that if any of the statements are willfully
false, I am subject to punishment.
*
If this requested information is being electronically returned to the requester please be aware that the MVC follows certain protocols regarding the
encryption of data in emails to maintain compliance with modern information security standards. As the requester, it is your responsibility to ensure
the data being sent electronically to the requester’s email can be opened on your electronic device.
DATE______________________________ __________________________________________________________
SIGNATURE OF REQUESTER
(Original Signature Only – Signature Stamps Are Unacceptable)
Driver Records Management Bureau
P.O. Box 134
Trenton, NJ 08666-0134
609-292-7500
609-984-4407 (fax)
Suspension.Info@mvc.nj.gov
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

INDIVIDUAL RESTORATION REQUIREMENT APPLICATION (The State of New Jersey)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 13 May 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document