DMV Record Change Request Form - New Hampshire
STATE OF NEW HAMPSHIRE
DEPARTMENT OF SAFETY
DIVISION OF MOTOR VEHICLES
23 HAZEN DRIVE, CONCORD, NH 03305-0001
John J. Barthelmes
Commissioner of Safety
Richard C. Bailey Jr.
Director of Motor Vehicles
RECORD CHANGE REQUEST
Note: This request will change data on all DMV records (Registration, Driver License, Title, etc.)
Please complete form accordingly for permanent changes only.
1. Person’s Information: (Please Print)
FIRST MIDDLE LAST DATE OF BIRTH
DRIVER LICENSE NUMBER / NON
DRIVER IDENTIFICATION NUMBER
BEST CONTACT PHONE
2. Address Change: If you would like a replacement license/ID with the updated information go to any
DMV Office and you may purchase a replacement at a cost of $3.00.
STREET CITY/TOWN STATE ZIP CODE
Check this box if the legal address is the same as the mailing, if different please complete legal address below.
CITY/TOWN STATE ZIP CODE
Check this box if you wish to have your legal address appear on the back of your driver license or ID.
NOTE: If an updated license is requested, applicant must appear in person and present current license to any DMV office, at a cost of $3.00.
Please check if you wish to add the Veteran Indicator.
Office Use only: Cash □ Check □ Credit □
3. Name Change: Must appear in person at any DMV Office with supporting documentation.
Marriage Certificate, Divorce decree, Adoption decree, Court decree, Name Change Petition from Probate Court, Passport.
FIRST MIDDLE LAST SUFFIX (Jr. Sr. I, II, etc)
4. Other Personal Identification Information: To change Date of Birth you must appear in person
at any DMV Office with supporting documentation. Original or certified copy of Birth Certificate, valid
Passport or valid Military ID.
Height Weight Eye Color Hair Color Gender Date of Birth (mm/dd/year)
Check Here To Consent to Organ Donation pursuant to RSA 263:41.
Donation information will be provided to federally designated organizations so that your decision to donate may be
Check here to remove your consent to Organ and Tissue donation.
I, the undersigned applicant, certify under penalty of unsworn falsification pursuant to RSA 641:3, all
information provided is correct and true.
DSMV 30 (Rev 10/14)
DMV Record Change Request Form - New Hampshire PDF
Favor this template? Just fancy it by voting!
1 Page(s) | 788 Views | 2 Downloads
2 Page(s) | 1252 Views | 2 Downloads
1 Page(s) | 585 Views | 4 Downloads
1 Page(s) | 696 Views | 1 Downloads
1 Page(s) | 550 Views | 1 Downloads