Follow the steps to fill out the form accurately and efficiently.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In the designated spaces, enter your first name, middle initial, and last name. Ensure that all information matches your official documents.
3. Provide your mailing address including city, state, and zip code. Double-check for accuracy to avoid delays in correspondence.
4. Enter your birth date in the specified format. This information is crucial for identity verification.
5. Input your Alaska license or ID number, if applicable. If your license was surrendered, indicate that in the corresponding section.
6. Include your daytime phone number and email address for communication purposes.
7. Record the court case number related to your DUI conviction or Admin Per Se revocation in the appropriate field.
8. Attach the required documents, including verification from the Alcohol Safety Action Program or an approved treatment provider, as needed.
9. If applicable, include the non-refundable application processing fee of $100, and indicate your payment method.
10. Review all entries for accuracy. Once everything is complete, sign and date the certification statement at the bottom of the form.
11. Submit your completed form and any accompanying documents. You can mail, fax, or email your application as per the instructions provided.
12. After submission, keep a record of your application and any correspondence received from the Division of Motor Vehicles.

Start filling out your AK RMV 404C form online today to apply for your limited driving privileges.