OHIO DEPARTMENT OF PUBLIC SAFETY AGENCY NUMBER

BUREAU OF MOTOR VEHICLES

APPLICATION NUMBER
APPLICATION INFORMATION FOR STANDARD
OHIO DRIVER LICENSE OR ID CARD
Applicants are required to complete Column A of this form in order to apply for the following: Ohio Driver License (DL) [includes Commercial,
Operator, Motorcycle Only, Moped, or Motor Scooter], Ohio Identification Card (ID) [includes Temporary or Permanent], and Ohio
Temporary Instruction Permit Identification Card (TIPIC) [includes all classes]. Applicants must present acceptable documents.
BMV USE ONLY - Check the following box(es) that applies:
Ohio DL / ID / TIPIC has never been issued or is expired over 6 months Request a change/correction to Name, Date of Birth, Social Security Number, or
Ohio DL / ID / TIPIC was lost, stolen, damaged, destroyed, suspended, or License Number as permitted
confiscated (Ohio DL / ID / TIPIC is not presented) Non-U.S. Citizens must present all legal presence documentation OR an I-551,
Converting to Ohio DL from another state/country except U.S. Nationals
Naturalization: Recently Naturalized
COLUMN A COLUMN B (BMV USE ONLY)
Applicants must complete all of column A. Applicants must present documents to prove the 5 elements. If applying for a
MUST WRITE FULL LEGAL NAME duplicate or renewal, one document is acceptable when all conditions are
FIRST NAME met. PROOF OF NAME, DOB, AND U.S. CITIZENSHIP
Original or Certified Birth Record U.S. Naturalization Document
FULL MIDDLE NAME (state) ODRC I.D. Card
U.S. Passport / Passport Card ODYS I.D. Card
CURRENT LAST NAME Exp. Date Consular Report of Birth Abroad
U.S. NATIONAL PROOF OF NAME, DOB, AND LEGAL PRESENCE
RESIDENCE ADDRESS (No P.O. Box permitted) Original or Certified Birth Record U.S. Passport / Passport Card
(territory) Exp. Date
Consular Report of Birth Abroad Endorsement Page Number
CITY
PROOF OF NAME CHANGE (if applicable)
STATE ZIP Divorce Doc Marriage Doc Certified Copy of Court Ordered Name Change

SHIP CARD TO - ADDRESS (if different than listed above) ONE DOCUMENT TRANSACTION
(Specify Document)
CITY STATE ZIP PROOF OF SSN
SS Card W-2 1099 Pay Stub BMV 2161 (not SS eligible)
DATE OF BIRTH (MM/DD/YYYY) GENDER Other (specify)
Male Female NON-U.S. CITIZEN-Proof of Name, DOB & Legal Presence
SOCIAL SECURITY NUMBER Permanent Resident Card (I-551) Conditional Resident (I-551T)
Employment Authorization Card (I-766) Unexpired Foreign Passport
HEIGHT WEIGHT VISA (type / class) I-20 OPT / CPT DS-2019
I-94 I-797 PPR
HAIR COLOR EYE COLOR (case type)
Other (specify)
TELEPHONE NUMBER Legal Presence Document Exp. Date (Mandatory)
( )
PROOF OF OHIO STREET ADDRESS (No P.O. Box)
E-MAIL ADDRESS
No Address Change Document (specify)
Declared – Ohio DL / ID is unexpired or expired less than 6 mos (Excludes Temp Residents)
LEGAL PRESENCE IN UNITED STATES
U.S. CITIZEN NON-OHIO LICENSE OR ABSTRACT
U.S. NATIONAL (NON-U.S. CITIZEN) BASS SYSTEM DATA MATCH BASS PHOTOGRAPH
PERMANENT RESIDENT (NON-U.S. CITIZEN) NEW / OSC (No Data in System) No Photograph in BASS
TEMPORARY RESIDENT (NON-U.S. CITIZEN) Name BASS Photograph Match
Country of Citizenship _________________________________ DOB BASS Photograph Mismatch (must
SS Number complete investigative review)
WARNING: IT IS A CRIMINAL OFFENSE TO GIVE DISCREPANCY Name DOB SS Number
FALSE INFORMATION ON THIS APPLICATION.
DOCS. FOR RESOLUTION
Under penalty of law, I affirm that the above information is
true to the best of my knowledge and belief.
SIGNATURE OF APPLICANT (Must be signed in front of the processing employee) DATE
X
SIGNATURE OF PROCESSING EMPLOYEE *SIGNATURE OF REVIEWER
X X
*If processing employee is not a Deputy Registrar or supervisor, reviewer must be a Deputy Registrar or supervisor.
If applicant is assisted with completing this form, print name of assistant and their DL / ID number, if available:

BMV 5745 1/24 [760-1491]

 OHIO DEPARTMENT OF PUBLIC SAFETY AGENCY NUMBER
BUREAU OF MOTOR VEHICLES
APPLICATION NUMBER
APPLICATION INFORMATION FOR COMPLIANT
OHIO DRIVER LICENSE OR ID CARD
Applicants are required to complete Column A of this form in order to apply for the following: Ohio Driver License (DL) [includes Commercial,
Operator, Motorcycle Only, Moped, or Motor Scooter], Ohio Identification Card (ID) [includes Temporary or Permanent], and Ohio
Temporary Instruction Permit Identification Card (TIPIC) [includes all classes]. Applicants must present acceptable documents.
BMV USE ONLY - Check the following box(es) that applies:
Compliant Ohio DL / ID / TIPIC has never been issued or is expired over 6 months Request a change/correction to Name, Date of Birth, Social Security
Ohio DL / ID / TIPIC was lost, stolen, damaged, destroyed, suspended, or Number, or License Number as permitted
confiscated (Ohio DL / ID / TIPIC is not presented) Non-U.S. Citizens must present all legal presence documentation OR an
I-551, except U.S. Nationals
Converting to Compliant Ohio DL from another state/country
Naturalization: Recently Naturalized
COLUMN A COLUMN B (BMV USE ONLY)
Applicants must complete all of column A. Applicants must present documents to prove the 5 elements. If applying for a duplicate
or renewal, one document is acceptable when all conditions are met.
MUST WRITE FULL LEGAL NAME
FIRST NAME PROOF OF NAME, DOB, AND U.S. CITIZENSHIP
Original or Certified Birth Record U.S. Naturalization Document
(state) I-797 Case Type I-565
FULL MIDDLE NAME U.S. Passport / Passport Card Consular Report of Birth Abroad
Exp. Date
CURRENT LAST NAME
U.S. NATIONAL PROOF OF NAME, DOB, AND LEGAL PRESENCE
Original or Certified Birth Record U.S. Passport / Passport Card
RESIDENCE ADDRESS (No P.O. Box permitted) (territory) Exp. Date
Consular Report of Birth Abroad Endorsement Page Number
CITY PERMANENT RESIDENT – Proof of Name, DOB, and Legal Presence
Permanent Resident (I-551) Conditional Resident (I-551T) Exp. Date
STATE ZIP
TEMPORARY RESIDENT – Proof of Name, DOB, and Legal Presence
Applicant must present documents from each column (cannot be the same document in both
SHIP CARD TO - ADDRESS (if different than listed above) columns, supplemental document must be verifiable through SAVE)
Main Document Supplemental USCIS Document
Employment Authorization Card (I-766) Employment Authorization Card (I-766)
CITY STATE ZIP
Unexpired Foreign Passport I-94
Visa Type I-20 OPT/CPT DS-2019
DATE OF BIRTH (MM/DD/YYYY) GENDER With I-94 I-797 PPR
Case type
☐ Male Female Compliant Ohio DL/ID/TIPIC
Other (specify)
SOCIAL SECURITY NUMBER Exp. Date Exp. Date
PROOF OF NAME CHANGE (if applicable)
HEIGHT WEIGHT Divorce Doc Marriage Doc Certified Copy of Court Ordered Name Change
PROOF OF SSN
HAIR COLOR EYE COLOR SS Card W-2 1099 Pay Stub
PROOF OF OHIO STREET ADDRESS (No P.O. Box)
TELEPHONE NUMBER Document 1 Document 2
( ) No Address Change Declared – Compliant Ohio DL / ID is unexpired or
expired less than 6 mos.
E-MAIL ADDRESS
ONE DOCUMENT TRANSACTION
(Specify Document)
LEGAL PRESENCE IN UNITED STATES
NON-OHIO LICENSE OR ABSTRACT
U.S. CITIZEN
BASS SYSTEM DATA MATCH BASS PHOTOGRAPH
U.S. NATIONAL (NON-U.S. CITIZEN) NEW / OSC (No Data in System) No Photograph in BASS
PERMANENT RESIDENT (NON-U.S. CITIZEN) Name DOB BASS Photograph Match
TEMPORARY RESIDENT (NON-U.S. CITIZEN) SS Number BASS Photograph Mismatch (must
complete investigative review)
Country of Citizenship _________________________________
DISCREPANCY Name DOB SS Number
DOCS. FOR RESOLUTION

WARNING: IT IS A CRIMINAL OFFENSE TO GIVE FALSE INFORMATION ON THIS APPLICATION. Under penalty of law, I affirm that
the above information is true to the best of my knowledge and belief.
SIGNATURE OF APPLICANT (Must be signed in front of the processing employee) DATE
X
SIGNATURE OF PROCESSING EMPLOYEE *SIGNATURE OF REVIEWER
X X
*If processing employee is not a Deputy Registrar or supervisor, reviewer must be a Deputy Registrar or supervisor.
If applicant is assisted with completing this form, print name of assistant and their DL / ID number, if available:

BMV 5745 1/24 [760-1491]