Get Dl 804

Filling out the DL 804 form is an essential step for participants in a DUI program to certify their enrollment or completion. This guide provides clear, step-by-step instructions to help you accurately complete the form online.

Follow the steps to fill out the DL 804 form online

1. Click ‘Get Form’ button to initiate the process and open the form in your browser.
2. In the 'PROGRAM PROVIDER NAME' field, input the name of the organization that provided the DUI program.
3. Fill in the 'PARTICIPANT NAME' section with the participant’s last name, first name, and middle initial.
4. Enter the provider’s ADP license number in the designated field to identify the program provider.
5. Specify the participant's driver license number or ‘X’ number accordingly.
6. Choose the appropriate 'PROGRAM TYPE' by selecting the relevant option: 'Education Only,' 'Multiple Offender Program,' or 'First Offender Program.'
7. Indicate the 'ENROLLMENT DATE' by entering the relevant date of enrollment.
8. For program duration, select the duration option that accurately reflects the program: 18 months, 30 months, or 18 of 30 months for IID restriction only.
9. Input the 'COMPLETION DATE' if the program has been completed.
10. Fill in the 'DL 107 CERTIFICATE NUMBER' or 'DL 101 CERTIFICATE NUMBER' if applicable.
11. Sign the form as a participant by entering the 'PARTICIPANT’S SIGNATURE.'
12. Provide the telephone number in the specified field to ensure proper communication.
13. Once all information is accurately filled out, save changes. You have the options to download, print, or share the completed form as needed.

Complete your documents online with confidence!