
OutofState Ignition Interlock Status Verification Outofstate ignition interlock companies must use this form to report ignition interlock activity. Instate vendors must use our portal to submit all.
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How to fill out the WA DR-500-011 online
The WA DR-500-011 form is used by out-of-state ignition interlock companies to report ignition interlock activity. This guide provides clear, step-by-step instructions to help you complete the form online efficiently and accurately.
Follow the steps to fill out the WA DR-500-011 form online.
- Click the 'Get Form' button to access the WA DR-500-011 and open it in the online editor.
- Begin by entering the driver's name in the format Last, First, Middle initial. Ensure clarity by printing or typing the information.
- Input the driver's date of birth and driver license number in the designated fields.
- Fill in the mailing address of the driver, including the city, state, and ZIP code.
- For the activity section, check one box only that corresponds to the activity being reported, such as installation, compliant, non-compliant/non-functioning, removal, or compliance release. Include the relevant date next to the selected activity.
- Indicate if any incidents have occurred within the specified time frame. Make sure to include details if there have been any attempts to start the vehicle with a breath alcohol concentration of .04 or more, or any missed vendor appointments.
- Next, provide details about the vehicle, including make/model, year, vehicle identification number (VIN), and license plate number.
- Fill in the device number related to the ignition interlock system.
- Complete the company section by typing or printing the ignition interlock company name and provide the Washington business license number.
- Add the name of the company representative and phone number, ensuring to include the area code.
- Finally, include the mailing address of the company, including city, state, and ZIP code.
- Once all fields are filled out, save your changes, download the completed form, print it for submission, or share it as needed.
Complete your WA DR-500-011 form online today to ensure timely and accurate reporting.
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