TC94177 Rev.08/2015 Page1of1 KENTUCKY TRANSPORTATION CABINET Department of Vehicle Regulation DIVISION OF DRIVER LICENSING CERTIFICATE OF INSTALLATION FOR IGNITION INTERLOCK DEVICE INSTRUCTIONS This.

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How to use or fill out the TC 94-177.docx - Transportation Ky online

Filling out the TC 94-177 form, required for the installation of an ignition interlock device, is a crucial step for obtaining the necessary licensing. This guide provides clear instructions to ensure accurate completion of the form online, facilitating a smooth process.

Follow the steps to successfully complete the TC 94-177 form online.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin with Section 1: Driver Information. Fill in your full name, mailing address, city, state, and zip code. Ensure all details are accurate to avoid delays.
  3. Continue with your residential street address. Provide your driver license number, plate number, vehicle identification number (VIN), year, and make/model of the vehicle.
  4. Move to Section 2: Installer Statement Information. Enter the name and phone number of the installer, along with their street address, city, state, and zip code.
  5. Proceed to Section 3: Device Provider Information. Include the company name, address, city, state, and the phone number of the device provider. If applicable, add the P.O. Box and the device model number.
  6. In Section 4: Signature & Date, the installer must print their name and record the installation date. Finally, ensure they provide their signature.
  7. Once all sections are filled out completely, save your changes. You may also download, print, or share the completed form as needed.

Complete the TC 94-177 form online today to ensure a timely submission!

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