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Get MI BDVR-162 2019

Requests received after 4 00 p.m. Eastern Time will be processed on the next business day. Please allow 7-10 business days to process requests sent by mail. Mail completed application with a check or money order payable to State of Michigan to Michigan Department of State Special Services Branch 7064 Crowner Drive Lansing Michigan 48918 BDVR-162 03/19. APPLICATION FOR DRIVER S LICENSE REINSTATEMENT Clear Form PLEASE PRINT OR TYPE NAME FIRST MIDDLE LAST STREET ADDRESS CITY STATE ZIP MAILING ADDRESS if different from Street Address DAYTIME TELEPHONE NUMBER - EXTENSION FAX NUMBER MICHIGAN DRIVER S LICENSE NUMBER DATE OF BIRTH PAYMENT METHOD check one REINSTATEMENT FEE TYPES check those applicable Money Order payable to the State of Michigan Standard 125. 00 Check payable to the State of Michigan Minor in Possession MIP 125. 00 Credit Card State of Michigan only accepts Discover MasterCard or VISA Drug Crime 125. 00 A nominal processing fee may be charged* Friend of the Court Compliance Certificate must accompany payment 85. 00 COMMENTS Watercraft 125. 00 Snowmobile 125. 00 Credit Card Expiration Date Credit Card Number / Enter Total Fees Here NAME ON CREDIT CARD PLEASE PRINT My signature below authorizes the Michigan Department of State to charge my account. Signature of Cardholder Date If paying by credit card you may fax this completed application to 517 322-5438. APPLICATION FOR DRIVER S LICENSE REINSTATEMENT Clear Form PLEASE PRINT OR TYPE NAME FIRST MIDDLE LAST STREET ADDRESS CITY STATE ZIP MAILING ADDRESS if different from Street Address DAYTIME TELEPHONE NUMBER - EXTENSION FAX NUMBER MICHIGAN DRIVER S LICENSE NUMBER DATE OF BIRTH PAYMENT METHOD check one REINSTATEMENT FEE TYPES check those applicable Money Order payable to the State of Michigan Standard 125. 00 Check payable to the State of Michigan Minor in Possession MIP 125. 00 Credit Card State of Michigan only accepts Discover MasterCard or VISA Drug Crime 125. 00 Check payable to the State of Michigan Minor in Possession MIP 125. 00 Credit Card State of Michigan only accepts Discover MasterCard or VISA Drug Crime 125. 00 A nominal processing fee may be charged* Friend of the Court Compliance Certificate must accompany payment 85. 00 A nominal processing fee may be charged* Friend of the Court Compliance Certificate must accompany payment 85. 00 COMMENTS Watercraft 125. 00 Snowmobile 125. 00 Credit Card Expiration Date Credit Card Number / Enter Total Fees Here NAME ON CREDIT CARD PLEASE PRINT My signature below authorizes the Michigan Department of State to charge my account. 00 COMMENTS Watercraft 125. 00 Snowmobile 125. 00 Credit Card Expiration Date Credit Card Number / Enter Total Fees Here NAME ON CREDIT CARD PLEASE PRINT My signature below authorizes the Michigan Department of State to charge my account. Signature of Cardholder Date If paying by credit card you may fax this completed application to 517 322-5438. APPLICATION FOR DRIVER S LICENSE REINSTATEMENT Clear Form PLEASE PRINT OR TYPE NAME FIRST MIDDLE LAST STREET ADDRESS CITY STATE ZIP MAILING ADDRESS if different from Street Address DAYTIME TELEPHONE NUMBER - EXTENSION FAX NUMBER MICHIGAN DRIVER S LICENSE NUMBER DATE OF BIRTH PAYMENT METHOD check one REINSTATEMENT FEE TYPES check those applicable Money Order payable to the State of Michigan Standard 125. 00 Check payable to the State of Michigan Minor in Possession MIP 125. 00 Credit Card State of Michigan only accepts Discover MasterCard or VISA Drug Crime 125. 00 A nominal processing fee may be charged* Friend of the Court Compliance Certificate must accompany payment 85. .

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