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DL 208 A Public Service Agency TRAFFIC ACCIDENT RECORD CORRECTION REQUEST NAME DRIVER LICENSE NUMBER FINANCIAL RESPONSIBILITY CASE NUMBER MAILING ADDRESS DATE OF BIRTH VEHICLE LICENSE NUMBER CITY STATE ZIP CODE WORK OR DAYTIME PHONE NUMBER RESIDENCE ADDRESS IF DIFFERENT FROM MAILING ADDRESS IMPORTANT INFORMATION Do not use this form to correct information regarding a traffic violation/conviction. To correct traffic violations/ convictions use the form DL-207 Driver License Record Correction Request Traffic Violations/Convictions Only. I also certify that I have read and understood all instructions and warnings on this form including the above provisions of Penal Code Section 115 a. SIGNATURE DATE X DRIVER RETURN RESPONSE SECTION DMV USE ONLY SECTION No supporting documentation attached Missing signature DL 208 REV. The Department of Motor Vehicles DMV will use this form only to correct a traffic accident which was reported by the California Highway Patrol or other law enforcement agency through a Traffic Accident Report. DMV will be unable to correct any traffic accident information on your driver record without the appropriate documents submitted with this form* The original Traffic Accident Report must be submitted with this form accompanied by an amended or supplemental law enforcement Traffic Accident Report or an original signed letter of explanation* If a law enforcement officer did not prepare a traffic accident report or you are uncertain who reported it call DMV s Financial Responsibility Unit at 916 657-6677. This form and any documents that support your request should be sent to the following address DEPARTMENT OF MOTOR VEHICLES Mandatory Actions Unit M/S J-233 P. O. Box 942890 Sacramento CA 94290-0001 Please allow four to six weeks from the date of submission for the DMV to review and respond to your request. If you have any questions please call 916 657-6525. We recommend you keep copies of this completed form and any accompanying documents for your personal records. I was not involved in a traffic accident that occurred in or near I was not at fault in the accident that occurred in or near CITY/COUNTY ON THE DATE OF Penal Code Section 115 a states every person who knowingly procures or offers any false or forged instrument to be filed registered or recorded in any public office within this state which instrument if genuine might be filed or registered or recorded under any law of this state or the United States is guilty of a felony. I certify under penalty of perjury under the laws of the State of California that the above information is true and correct. I also certify that I have read and understood all instructions and warnings on this form including the above provisions of Penal Code Section 115 a. SIGNATURE DATE X DRIVER RETURN RESPONSE SECTION DMV USE ONLY SECTION No supporting documentation attached Missing signature DL 208 REV. 3/2006 WWW Record correction updated on NOTE You may go to any DMV field office and pay 5. 00 if you wish to get a copy of your updated driver record.

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