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Get OR DMV Form 735-171B 2014-2024

If I am convicted of such act(s), I can be fined and/or sentenced to jail. Disclosure of my Social Security number is mandatory and may be used for: enforcing child support laws; for verifying identity and residency; and by other government agencies who request it from DMV. (ORS 25.785, ORS 807.021, ORS 807.050, OAR 735-062-0005). I also certify that I am a resident of or domiciled in Oregon as required by ORS 807.062 and 807.400. SIGNATURE OF APPLICANT DATE OF SIGNATURE X 735-171B (1-14) E.

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