PERMIT or NON-DRIVER ID CARD - Personal Information, Address, and Consent Section

Sep 19, 2026

PERMIT or NON-DRIVER ID CARD application instructions and fields include personal identifiers such as your full name, suffix, sex, and date of birth, plus a social security number requirement and authorization for its collection and use. The form collects name change history, veteran status and proof of honorable discharge, and participation in New York State organ and tissue donation through the Donate Life registry consent choices. It also requests residential and mailing address details, including apartment, city, state, zip, and county, plus office-use selections and applicant eligibility questions.

LanguageEnglish

CategoryForms

FormatPDF

Pages2

Reading Time1 min

AccessFree to download

Personal information

Name, date of birth, and SSN

Veteran status and proof

Organ and tissue donation (Donate Life)

Address details

Where you live

Mailing address changes

Office and eligibility sections

Proof submitted and approvals

Driver license and medical eligibility questions

Parent/guardian consent

PERMIT,or NON-DRIVER ID CARD | | | | | | | | | | | --- | --- | --- | --- | --- | --- | --- | --- | --- | prove your ful name.Your full name willappear on your document. SUFFIX SEX DATE OF BIRTH Month Day Year Male Female Has your name changed?□Yes □No if"Yes",print your former sOCIAL SECURITY NUMBER*(SSN)*You must provide your SSN.Authority to collect your SSN is grantedby Sections 490.3 and 502 of the Vehicle and | | | | Traffic Law.T
identity,and to in | | --- | --- | --- | --- | he information willbe used only for exchange with other jurisdictions,to assist in verification of voke driver license sanctions pursuant to V&T Law Section 510(4-e)and 510(4-+).Your number will not be given to the public,or appear on any form or information request. -Include Street Number and Name,Rural Delivery and/or box number (If PO Box,alsofillin"Address Where You Live"below) | | Apt.No. | City or Town | State | Zip Code | County | | --- | --- | --- | --- | --- | --- | ADDRESS WHERE YOU LIVE REQUIRED IF DIFFERENT FROM ADDRESS FOR MAIL-DO NOT GIVEP.O.BOX.THIS ADDRESS WIILLAPPEAR ON YOUR DRIVER LICENSE. | | Apt.No. | City or Town | State | Zip Code | County | | --- | --- | --- | --- | --- | --- | HAS YOUR MAILING ADDRESS CHANGED?□Yes □No HAS THE ADDRESS WHERE YOU LIVE CHANGED?□Yes □No (new license class,wrong date of birth,etc.)? | VETERAN STATUS | □Check this box if you would like to have "Veteran"printed on the front of your photo document.
You must present prof that indicates an honorable discharge from military service.For aditional information,please see form MV-44.1EDL. | | | --- | --- | --- | | NEW YORK STATE ORGAN AND TISSUE DONATION(You must fill out the following section)
To enroll in the New York State Donate LifeSM Registry,check the "yes"box and then sign and date below.You are certifying that you are:16 years ofi
age or older;consenting to donate your organs and tissues for transplantation and research;authorizing DMV to transfer your name and identifying
information to the Donate Life Registry;and authorizing Donate Lie NYS to give access to this information to federally regulated organ donation
organizations and NYS-licensed tissue and eye banks and hospitals,upon your death."ORGAN DONOR"will be printed on the ront of your DMV photo
document.You will receive a confirmation,which willaalso provide you an opportunity to limit your donation.If you are 16 or 17 years of age,
parentslegal guardians may change your decision upon your death.For more information,contact DLNYS at donatelife.ny.gov
You must answer the following question:Would you like to be added to the Donate Life Registry?□Yes (sign and date consent below)
□skip This Question
Donor Consent Signature:
Date:_ | | □Check this box to make a
$1 voluntary donationto the
Life...Pass It On Trust Fund
for organ and tissue donation
research and outreach.Your
total transaction fee will
indude the$1. | | PLEASE COMPLETE AND SIGN PAGE 2. | | | | | | | | | | --- | --- | --- | --- | --- | --- | --- | --- | --- | | FOR OFFICE USE | Other
Restrictions | | | | | License
Class | NCDL-C
D
C
B
A
DJ
ID
M
MJ
E | | | | Endorsements | | | | | Special
Conditions | LS
BC
TR
LR
DP
AM
ML
XT
X8
UR
UP
TD
NF
UC | | | | NI
EA
EI
NA
CDL Certifications | | | | | | | | | | □TEENS | | Proof Submitted:
□Driver License/ID □
□
DHS Document(s)
Social Security Card
□creit Card
口
Birth Certificate
□Learner Permit
Medical Certificate (CDL Only)
□MV-45
□U.S.Passport
□Image Retrieval
ATM Card
□Foreign Passport
□out of-State-License
Other: | | | | | Date

FAQs

What personal information and identifiers are required for the permit or non-driver ID card application?

The form requests your full name, suffix, sex, and date of birth. It also requires your social security number (SSN).

What is the SSN authorization used for?

The form states that the information is used only for exchange with other jurisdictions to assist in verification and to invoke driver license sanctions under specified law sections. It also notes the number will not be given to the public or appear on forms or information requests.

How do organ donation and veteran status options work on this form?

Organ donation requires selecting the Donate Life Registry consent option and signing and dating. Veteran status requires checking the box and presenting proof of an honorable discharge; additional information is referenced to form MV-44.1EDL.

Sep 19, 2026

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