Parental/Legal Guardianship Consent Form (under age 18)
Government of the District of Columbia
Department of Motor Vehicles
Parental/Legal Guardianship Consent Form (under age 18)
This form is required to obtain any DC DMV Credential for all individuals under the age of 18
Applicant Full Name (First, Middle, Last, Suffix)
Date of Birth
DC Address
Sex
Social Security #
? Male
? Female
? Neutral
Zip Code
City, State
Telephone #
Washington, DC
? Parent
? Legal Guardian*
Relationship to Applicant (Check one)
Full Name of Parent or Legal Guardian
(First, Middle, Last, Suffix)
*If Legal guardian, provide court decree number:
Date of Birth
Sex
Telephone #
? Male
? Female
? Neutral
City, State
Address
Zip Code
Washington, DC
DC Driver License or Identification Card Number
Expiration Date
Email Address
Parental/Legal Guardianship Verification
One of the following documents is required depending on your relationship to the applicant
Parent
?
Legal Guardian
Full birth certificate of applicant or adoption court order
reflecting parent¡¯s name
?
Guardianship decree
Any person using a fictitious name or address and knowingly making any false statement on this application is in violation of DC Law and subject
to a fine of not more than $1,000 or 180 days imprisonment or both. (D.C. Official Code ¡ì22-2405)
I hereby certify that the information provided on this document is true and accurate to the best of my knowledge and belief.
Signature of Parent/Legal Guardian:_______________________________________________________Date:________________________________
For DMV Official Use Only
DMV Examiner¡¯s Signature:__________________________________________________________Date:__________________________
If you have questions, please visit our website, dmv., or call 311 in DC or 202-737-4404 outside the 202 area code.
To confidentially report waste, fraud or abuse by any DC Government Agency or official, call the DC Inspector General at 1-800-521-1639.
DMV-PCF-01 Rev.4/2019
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