Follow the steps to successfully complete your application.

1. Press the ‘Get Form’ button to access the form and open it in your chosen editing tool.
2. Indicate the reason for your request by selecting either 'Interim' or 'Extension'. Choose 'Interim' if your driver’s license is lost or stolen but not expired, and you are at least fifty miles outside Indiana. Choose 'Extension' if your driver’s license has expired and you are at least fifty miles outside Indiana.
3. Enter your Indiana Driver's License Number and the Date of Expiration in the required format (mm/dd/yyyy). Ensure these details are accurate to avoid delays.
4. Provide your legal name as it appears on your Indiana credentials. Include your first, middle, and last name without any abbreviations.
5. Fill in your Indiana legal address, making sure this matches the address on record with the Bureau of Motor Vehicles. Include your address number and street.
6. Input the last four digits of your Social Security number as required. Remember that disclosure is mandatory for processing.
7. Provide your Date of Birth in the format (mm/dd/yyyy). Ensure this information is accurate to validate your identity.
8. Enter your telephone number for any necessary follow-up or queries regarding your application.
9. Specify your expected date of return to Indiana in the required format (mm/dd/yyyy). This is important for the processing of your interim or extension license.
10. If applicable, fill out your temporary mailing address, including street number and city.
11. Provide your email address for correspondence regarding your application status or further instructions.
12. Include a signature affirming the truthfulness of the information provided on the form. Make sure to print your name and include the date of signing in the required format (mm/dd/yyyy).
13. Review the completed form for accuracy, ensuring all necessary fields are filled out correctly, and then save any changes.
14. You can now download, print, or share the completed form as per your requirement, and mail it to the Indiana Bureau of Motor Vehicles at the address provided.

Complete your Request For Interim / Extension License online today and ensure your driving privileges while away from Indiana!