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Get SC DMV DL-222 2011

South Carolina Department of Motor Vehicles DL-222 Rev. 8/11 CHANGE OF RESIDENCY AFFIDAVIT SECTION I To be completed by the applicant. Reference 446 Name of Applicant S*C. Driver License No Date of Birth Customer s Home No Cell Phone No Work Phone No Under penalties of perjury I declare that the following facts concerning my change of residency from South Carolina are true and correct 1. On the day of I became a resident in the state of My current address is 2. I applied for a driver s license in the above referenced state on the 3. I do not wish to obtain a South Carolina Driver s License. Signature of Applicant Subscribed and sworn to me this Date My commission expires on Signature of Notary Public Seal The above named person has applied to receive a license in this state. If a DMV Official from South Carolina certifies that the applicant s S*C. drivers license is not under suspension the applicant is eligible for a Class License in the State of DMV Official Title Area Code Telephone Number The SR-22 Certificate of Insurance requirement has been waived*. Reference 446 Name of Applicant S*C. Driver License No Date of Birth Customer s Home No Cell Phone No Work Phone No Under penalties of perjury I declare that the following facts concerning my change of residency from South Carolina are true and correct 1. On the day of I became a resident in the state of My current address is 2. I applied for a driver s license in the above referenced state on the 3. On the day of I became a resident in the state of My current address is 2. I applied for a driver s license in the above referenced state on the 3. I do not wish to obtain a South Carolina Driver s License. Signature of Applicant Subscribed and sworn to me this Date My commission expires on Signature of Notary Public Seal The above named person has applied to receive a license in this state. I do not wish to obtain a South Carolina Driver s License. Signature of Applicant Subscribed and sworn to me this Date My commission expires on Signature of Notary Public Seal The above named person has applied to receive a license in this state. If a DMV Official from South Carolina certifies that the applicant s S*C. drivers license is not under suspension the applicant is eligible for a Class License in the State of DMV Official Title Area Code Telephone Number The SR-22 Certificate of Insurance requirement has been waived*. Reference 446 Name of Applicant S*C. Driver License No Date of Birth Customer s Home No Cell Phone No Work Phone No Under penalties of perjury I declare that the following facts concerning my change of residency from South Carolina are true and correct 1. On the day of I became a resident in the state of My current address is 2. I applied for a driver s license in the above referenced state on the 3. I do not wish to obtain a South Carolina Driver s License. Signature of Applicant Subscribed and sworn to me this Date My commission expires on Signature of Notary Public Seal The above named person has applied to receive a license in this state. .

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