Employer Declaration for Ignition Interlock License

State:
Multi-State
Control #:
US-03193BG
Format:
Word; 
Rich Text
Instant download

What is this form?

The Employer Declaration for Ignition Interlock License is a legal document that allows employees with a suspended or revoked driver’s license due to DUI to operate employer-owned vehicles that do not have ignition interlock devices installed. This form serves to exempt the employer from the requirement to equip their vehicles with such devices while allowing the employee to drive for work-related purposes.

What’s included in this form

  • Employee information: Name and driver license number of the applicant.
  • Employer information: Company name, contact details, and address.
  • Declaration statement: A legal attestation by the employer under penalty of perjury.
  • Signature section: Employers must provide their printed name, signature, and date.
  • Business license number: Required for the employer to validate the organization.

Situations where this form applies

Intended users of this form

  • Employees with a DUI offense who have an Ignition Interlock Driver License.
  • Employers who own vehicles operated by such employees during work hours.
  • Individuals applying for driving exemptions based on employer declarations.

How to complete this form

  • Identify the employee: Enter the applicant’s full name and driver license number.
  • Provide employer details: Fill in the company name, contact number, and business address.
  • State the necessity: Mark that the employee needs to drive an employer-owned vehicle.
  • Complete the declaration: Ensure the employer signs and dates the form.
  • Mail the form: Send a copy to the relevant state department as indicated in the form.

Does this form need to be notarized?

Notarization is generally not required for this form. However, certain states or situations might demand it. You can complete notarization online through US Legal Forms, powered by Notarize, using a verified video call available anytime.

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Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.

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If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.

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We protect your documents and personal data by following strict security and privacy standards.

Avoid these common issues

  • Failing to include the employer’s business license number.
  • Not signing the form or skipping the date.
  • Omitting the employee's driver license number.

Benefits of completing this form online

  • Convenient access to a legal form that can be downloaded and filled out at your own pace.
  • Edit and customize the form according to your specific needs before printing.
  • Reliability of using a standard form drafted by licensed attorneys.

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FAQ

When you are charged with a DUI, you are liable to suffer a variety of penalties, most commonly a license suspension, fines and court fees, and potentially some jail time. Recently, many states have begun to require offenders to install an ignition interlock device, even for first-time DUI charges.

Ignition interlock devices are difficult to use or unreliable. Ignition interlocks can be bypassed by an air compressor or inflated balloon. You can drive without a court-ordered ignition interlock without any trouble. Ignition interlocks are harmful to vehicles.

If you want to drive after your licence is reinstated, you must have an ignition interlock device installed. You will need to register with an approved interlock service provider to have the device installed. It must be inspected regularly by the service provider.

All states allow drivers to submit a second breath test if they fail the first one. However, if they provide a second failed sample, they may experience a lockout. This means they will be unable to start the car after a certain amount of time passes.

If you attempt to bypass or remove your ignition interlock device before your 1-year requirement program is up, your driving privileges will be suspended.If your drivers license has already been reinstated, your license will be suspended again.

Generally speaking, failing an interlock test is considered a violation, and this data will be sent to your state regulatory authority. They will ultimately use this data to make a decision about your continued participation in the program.

Because Alcohol Interlock Devices can detect trace amounts of alcohol from other products, the effective limit required to operate your vehicle is BAC < 0.020.If you fail or miss a random/rolling retest (BAC recorded above 0.02) this is considered a violation.

Refusing or failing to get the device installed. Driving or even attempting to drive a vehicle without an IID. Failing one or more startup tests. Failing a rolling retest. Missing or intentionally skipping a rolling retest. Asking someone else to take the breath test for you. Tampering with or attempting to remove the IID.

There are many myths about tricking a car breathalyzer into believing a person hasn't been drinking. There are many myths about tricking a breathalyzer into believing a person hasn't been drinking. In short, beating a car breathalyzer, formally known as an ignition interlock device (IID), is nearly impossible.

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Employer Declaration for Ignition Interlock License