Follow the steps to accurately complete the revocation application.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering your full name in the customer section, ensuring that you list your first, middle, last, and suffix correctly.
3. Provide your driver license number and date of birth to help verify your identity.
4. Indicate whether you have been convicted of any traffic violations in Arizona within the last 12 months. If you answer yes, list the violation(s) and their corresponding dates.
5. Read the Authorization to Release Information section carefully. Fill in the name of your approved evaluator, then sign and date the form to authorize the release of information to the Motor Vehicle Division.
6. Complete the substance abuse evaluation portion of the application if applicable, ensuring that the approved evaluator submits their evaluation and certification to the Motor Vehicle Division.
7. If your application is related to a conviction for failure to stop at an accident involving death, ensure the Criminal Restitution Certificate is filled out by the appropriate authority and included with your application.
8. Review your completed application for any errors or missing information before finalizing.
9. Once you are satisfied with the accuracy of your application, save your changes. You may also download, print, or share the form as necessary.

Complete your AZ DoT 99-0139 revocation application online today to get one step closer to reinstating your driving privileges.