Fillable Online Renewal Standard Driver License Page 1 of (Montana Department of Justice)

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Online Renewal Standard Driver License Page 1 of (Montana Department of Justice)

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The Online Renewal Standard Driver License Page 1 of (Montana Department of Justice) form is 3 pages long and contains:

  • 3 signatures
  • 6 check-boxes
  • 84 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Montana Department of Justice

BROWSE MONTANA DEPARTMENT OF JUSTICE (MT) FORMS

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FOR OFFICAL USE ONLY
Online Renewal
Standard Driver License
Page 1 of 2
Primary ID __________________________
Secondary ID __________________________
C – K – M # ___________
Amount $ ___________
Date__________ __ Initials ___________
P.O. Box 201430, Helena, MT 59620-1430
Phone (406) 444-3933
Fax (406) 444-1631
www.dojmt.gov
DriverLicense@mt.gov
Please PRINT
Montana state authorities reserve the right to reject any form that has been altered.
25-0200 (3/20)
Page 1 of 2
This form is available in alternate formats for people with disabilities
Legal Last Name
Legal First Name
Legal Middle Name
Suffix (Jr., Sr., 1
st
, etc.)
Date of Birth (mm/dd/yyyy)
Sex
Hair Color
Are you a Montana Resident?
Female Male Yes No
Montana Residential Address
City
State
Zip Code
MT
Montana Mailing Address
City
State
Zip Code
MT
Which address would you like printed on your driver license?
MT Residential Address
MT Mailing Address
US address to mail license if away (cannot mail out of country)
City
State
Zip Code
Are you a United
States Citizen?
Yes
No
If “No” STOP. You must renew
in person or by mail.
Place of Birth: City/ State/Province/Country
Driver License Number
Social Security Number
Email Address
Daytime Phone Number
CHECK THE TYPE OF LICENSE YOU ARE
APPLYING FOR:
Driver License (Class D) Motorcycle Endorsement
No
No
No
Yes
No
Yes
No
If you are 15 or older, do you want your driver license or ID to show that you are an organ donor? > > > > > >
Yes
Not Now
If you are 18 or older, do you want your driver license or ID to show that you have a living will? > > > >
Yes
No
If you are under age 26 but at least age 15, do you consent to registration with the Selective Service System,
if required by federal law? (If under 18, you will be registered upon attaining age 18). > > > > > > >
Yes
No
Signature or type name if signing electronically:
Date:
I affirm under penalty of law (MCA 61-5-303) that the information on this application is true and correct, except for my
answer about sex, to the best of my knowledge, information, and belief. I understand that any false or misleading statement on
my application may result in criminal prosecution, cancellation of any license or card issued and/or my disqualification for a
period of 60 days.
1. In the past 10 years, have you held a valid driver license or commercial driver license from any jurisdiction (state)
other than Montana? If yes, list all states:
2. Do you have a current, pending, or previous suspension, revocation, cancellation, disqualification, or withdrawal
of your driver license or privilege to drive by the State of Montana or by another state or jurisdictio n >?> > >
3. Do you suffer from any chronic or potentially chronic condition that may cause a loss of consciousness or control?
4. Do you have any physical or mental condition that impairs or may impair your ability to exercise ordinary and
reasonable control in the safe operation of a motor vehicle on the highway? > > > > > > > > > > > > >
5. Do you rely on any adaptive equipment or operational restrictions to attain the ability to exercise ordinary and
reasonable control in the safe operation of a motor vehicle on the highway? > > > > > > > > > > > > >
6. Since your last driver license was issued, have you experienced any change in your medical condition that may
impair your ability to safely operate a motor vehicle? > > > > > > > > > > > > > > > > > > > > > >
7. Since your last driver license was issued, have you experienced any change in your vision that may impair your
ability to safely operate a motor vehicle > > > > > > > > > > > > > > > > > > > > > > > > > >
8. If you require vision correction or if there has been a change in your vision, is your vision prescription correct?
Yes
Yes
Yes
Yes
Yes
No
No
Other Services Offered:
Yes
No
Please complete both pages
click to sign
signature
click to edit
Online Renewal
Standard Driver License
Page 2 of 2
P.O. Box 201430, Helena, MT 59620-1430 Phone (406) 444-3933 Fax (406) 444-1631 www.dojmt.gov DriverLicense@mt.gov
Please PRINT
Montana state authorities reserve the right to reject any form that has been altered.
25-0200 (3/20)
Page 2 of 2
This form is available in alternate formats for people with disabilities
Receive Your Ballot in the Mail
Yes, I request an absentee ballot to be mailed to me for ALL elections in which I am eligible to vote as long as I
reside at the address listed on this application. I understand that if I file a change of address with the U.S. Postal Service,
I must complete, sign, and return a confirmation notice mailed to me by the county election office.
Voter Applicant Affirmation
I affirm under penalty of perjury that the information on this application is true, that I am a citizen of the United States, that
I will be at least 18 years old on or before the next election that I will have been a resident of Montana for at least 30 days
prior to the next election, and that I am not serving a felony conviction in a penal institution nor have been found to be of
unsound mind by a court. I understand that if I have given false information on this application, I may be subject to a fine
or imprisonment, or both, under federal and/or state law. By signing you authorize the Motor Vehicle Division to use your
electronic signature for voter registration purposes.
VOTER REGISTRATION: Please complete this section even if you are a registered voter.
Are you a citizen of the United States?
Will you be at least 18 years of age on or before the next election?
Will you be a Montana resident for at least 30 days before the next election?
If you checked “No” in response to any of these questions, this is the end of the application.
Previous Registration Information – will be used to provide cancellation information to former jurisdiction.
Required if name changed or if previously registered to vote in another MT county or in another state.
Previous Registration Name
Residence Address of Previous Registration
Previous City Previous County Previous State Previous Zip
Signature or type name if signing electronically:
Date:
The affirmation on this application for voter registration must be signed by the applicant. Failure to do so will
prevent application from being processed.
Where you submit this form and your decision to not vote is confidential, and this information can only be used for
voter registration purposes.
You can visit the Montana Secretary of State “My Voter Page” to check if you are registered to vote, check your
voter registration address, and find the location and directions to your polling place at: https://app.mt.gov/voterinfo/.
I want to register to vote or update my voter registration (continue on with application if selected)
I do not want to register to vote (end of application if selected)
I'm already registered to vote and do not want to update my information (end of application if selected)
County you are registering to vote in:
Yes No
Yes No
Yes No
Please complete both pages
Print form
click to sign
signature
click to edit
Change of Address for Driver
License or ID Card
(Electronic Record)
C – K – M # _________
Amount $ _________
Initials _________
P.O. Box 201430, Helena, MT 59620-1430 Phone (406) 444-3933
Fax (406) 444-3816 www.dojmt.gov MTDriverHistory@mt.gov
Please PRINT.
Montana state authorities reserve the right to reject any form that has been altered.
34-0300 (4/18) This form is available in alternate formats for people with disabilities.
Montana law mandates that the Motor Vehicle Division be notified within 10 days of any address change.
Legal Last Name
Legal First Name
Legal Middle Name
Suffix (Jr., Sr., 1
st
, etc.)
Date of Birth
Montana Driver License Number
Current Daytime Phone Number
Email Address
Montana Residential Address
City
State
MT
Zip Code
Montana Mailing Address
City
State
MT
Zip Code
Signature
Date
I affirm under penalty of law (MCA 61-5-303) that the information on this application is true and correct, except for my answer about sex, to the best of my knowledge, information, and belief.
click to sign
signature
click to edit
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Online Renewal Standard Driver License Page 1 of (Montana Department of Justice)

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Completed 9 March 2021

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