Get Request For Interim / Extension License

Filling out the Request for Interim/Extension License form can be a straightforward process if you follow the necessary steps carefully. This guide will walk you through each section of the form, ensuring that you provide the required information correctly and efficiently.

Follow the steps to successfully complete your request.

1. Press the ‘Get Form’ button to access the form and open it for editing.
2. Begin by filling in the legal name as it appears on your Indiana credential. Ensure that it includes your first name, middle name (if applicable), and last name.
3. Next, input your Indiana driver’s license number and the date of expiration in the specified format (mm/dd/yyyy).
4. Provide the last four digits of your Social Security number in the designated field. Remember that disclosure is mandatory, and the processing of the application cannot proceed without this information.
5. Enter your Indiana legal address, ensuring that it matches the address in the Bureau of Motor Vehicles' records to avoid denial of your request.
6. Fill in your expected date of return to Indiana, also in the format of mm/dd/yyyy, which should be within a sixty-day timeframe to ensure processing of your request.
7. If applicable, provide your temporary mailing address, including the city, state, and ZIP code.
8. Fill in your date of birth in the specified format (mm/dd/yyyy).
9. Provide your telephone number and email address for any necessary communication regarding your request.
10. Review all the information entered to ensure that it is accurate and complete before signing the form. Your signature is required to confirm that the information provided is true and correct.
11. The last step involves dating the form (mm/dd/yyyy) and preparing it for submission. You can save changes, download, print, or share the completed form as needed before sending it to the specified address or faxing it.

Complete your Request for Interim/Extension License online today to ensure smooth processing.