Service Center Class D
Resume:
Confirmation Number: 1-691-***-***
To complete your transaction, please present this application, as well as any of the documentation you selected in the application. Please note that laminated documents will NOT be accepted during your service center visit. All documents must be originals, photocopies will not be accepted.
Dear ESTEVENSON JOSEPH I,
Thank you for applying for your Class D Passenger Permit. Listed below is a summary of the information you entered. If this information is not correct, please notify us during your visit to RMV Service Center. If you have not already made an appointment please visit Mass.Gov/RMV to make an appointment for an RMV Service Center. Documents Required
If you cannot present any of the required documents at the time of your transaction, you must present documents from our acceptable documentation list, which can be found at https://www.mass.gov/guides/massachusetts-identification-id-requirements. These documents must be submitted no later than 60 days from the date of this letter. I affirm under the penalties of perjury that the information provided is true and accurate. I further understand that providing false statements or information is punishable and subject to both imprisonment and a civil driver’s license suspension pursuant to M.G.L. c.90, §24B.
Applicant Signature Applicant SSN Date Bank Statement - Additional Account for Proof of Residency Requirement Affidavit of No SSN for Proof of Social Security Status Requirement Unexpired Foreign Passport for Proof of Identity and Date of Birth Requirement I-94 Arrival/Departure Record for Secondary Proof of Identity and/or Date of Birth Requirement Requirement Letter from Doctor
Actions Required at Service Center
Vision test is required.
Name: ESTEVENSON JOSEPH I
Date of Birth: 6/26/1982
Residential Address: 20 CONNECTICUT PLACE BROCKTON 20 CONNECTICUT PLACE BROCKTON FL 0000 BROCKTON MA 02301-0000
Registering to Vote?: NO
Gender: MALE
Eye Color: BLACK
Height: 1 FT 2IN
Military: N/A
Registering as an Organ and Tissue Donor?: NO
Applying for a Real Credential?: NO
Total Due: $30.00
Massachusetts Registry of Motor Vehicles P.O. Box 55889, Boston, MA 02205-5889 mass.gov/rmv Clerk Initials Date
Thank you for choosing mass.gov/rmv as your Service Center of choice. Keep up to date with RMV updates by following us at www.twitter.com/massrmv
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