Fillable Printable Form MV-45 - Statement of Identity by Parent/Guardian - New York

Form MV-45 - Statement of Identity by Parent/Guardian - New York

New York State Department of Motor Vehicles

STATEMENT OF IDENTITY AND/OR RESIDENCE BY PARENT/GUARDIAN

Use this form if you are under age 21 and cannot provide enough proofs from one or both of the following:

ä “Proof of Name” list on form ID-44 or ID-82 (Proofs of Identity);

ä “Proof of Residence” list on form ID-44EDL (Proofs of Identity, Citizenship and Residence). One additional

proof of residence that is in the name of the person who is under age 21 or in the name of the parent or the

guardian must be submitted with this statement.

NOTE: Proof of residence is required only with applications for an enhanced document.

Your parent or guardian can verify your identity, or residence, or both by following these steps:

ä You must bring your parent or guardian with you to the Motor Vehicles office when you use this form.

ä Your parent or guardian must complete the information below with a Motor Vehicles Representative present.

ä You must present proof of your date of birth with this form. If you apply for a license, permit, or a

non-driver identification card, you must also meet the Social Security card requirement on form ID-44.

ä Documentation must be submitted to prove the identity of your parent or guardian.Your parent or guardian must

provide a valid New York State driver license, a learner permit or a non-driver identification card or meet the proof of

identity requirements on form ID-44.

IMPORTANT: DO NOT SIGN THIS FORM UNTIL YOU ARE WITH A MOTOR VEHICLES REPRESENTATIVE.

I, ___________________________________________________________________, certify as the parent/legal

guardian of_____________________________________________________________________, who resides at

__________________________________________________________________________________________

that this name is the name by which (s)he is commonly known and that (s)he resides at the address above. To the

best of my knowledge, (s)he has not obtained or applied for a learner permit, non-driver identification card, or

driver license in any other name. I understand that any false statement I have made on this certification is a

misdemeanor under Section 392 of the Vehicle and Traffic Law.

Parent/Guardian Sign Here

ç ____________________________________________________________

Parent/Guardian Print Name Here: ______________________________________________________________

Identification No. from Driver License, Learner Permit or Non-Driver ID Card: __________________________

Print Your

Mailing Address:

____________________________________________________________________________________

IMPORTANT:

DO NOT SIGN THIS FORM UNTIL YOU ARE WITH A MOTOR VEHICLES REPRESENTATIVE.

APPLICANT SIGNATURE ç ______________________________________________

OFFICE USE ONLY

Proofs of Identity Presented by Parent/Guardian:

o Birth Certificate o NYS Photo Document o INS Paper o Major Credit Card

o Passport o Utility Bill o Social Security Card

o Other: ____________________________________________________________________________________________

Signature of Person Accepting Proof ç ____________________________________________________________

Title of Person Accepting Proof: ________________________________________________ Date ____________

MV-45 (9/12)

(Name of Parent/Guardian)

(Name of Applicant)

(Address)

CERTIFICATION