Re

ne
w
Steps to Renew Your
Massachusetts Driver’s License
Checklist

In Person

Print this guide. Make sure to use one-sided printing.

Review the pre-filled information.

Sign and date the application.

Gather your supporting documents.

Visit your nearest Registry of Motor Vehicles (RMV) office.

Submit your application and supporting documents.

Pay the renewal application fee. At most locations, you have the option to pay
by money order, check, card, or cash. Make sure to verify the payment options
with your RMV office before your visit:

• Class D License: $50

DO NOT INCLUDE THIS PAGE IN YOUR PACKAGE

Build your package

Instructions
Keep in mind that your supporting documents must be originals, and you must use a separate document
for each of the following requirements:

Your current driver’s license or identification card

1 document as proof of lawful presence, such as a:

• Valid U.S. passport document.

• Certified copy of a U.S. birth certificate.

• Valid Permanent Resident Card.

• Certificate of Citizenship.

• Certificate of Naturalization.

1 document as proof of Social Security Number (SSN), including but not limited to:

• An unlaminated SSN card

• A W-2 form

• An SSA-1099 form

• A paystub with the full SSN

2 documents as proof of residency in Massachusetts, such as:

• Mail sent from the Registry of Motor Vehicles (RMV) in the last 60 days.

• Mail sent from a government entity in the last 60 days.

• A recent property or excise tax document.

• A utility bill from within the last 60 days.

• A recent school transcript.

DO NOT INCLUDE THIS PAGE IN YOUR PACKAGE

Massachusetts Driver’s License Renewal Form LIC-100

Driver’s License, Learner’s Permit

or ID Card Application
(Passenger (Class D), Motorcycle (Class M), Class D/M, or Massachusetts Identification Card)

A. Service Type
1. Type: REAL ID  Standard ID

2. Document to Issue: Learner’s Permit  Driver’s License  Massachusetts ID Card

3. Class of Learner’s Permit/License (if applicable): Passenger (Class D) Motorcycle (Class M) Both (Class D/M)

4. Service Type: New Renewal Replacement Out-of-State Conversion Reinstatement CDL Downgrade
 Change of Information (Enter new information in applicable fields): Name Address DOB Gender Height Eye Color

B. Applicant Information
Last Name (If you’re getting a REAL ID, provide your full legal name) First Name Middle Name Suffix

Current Massachusetts Learner’s Permit or Driver’s License # (if applicable) Date of Birth (MM/DD/YYYY)

What is your Social Security Number? If you do not have a Social Security Number, you will need an SSA Denial notice & Foreign Passport.

Foreign Passport #
Residential Address (Where you actually reside)

Street Apt. # City State Zip Code

Mailing Address  (same as above)

Street Apt. # City State Zip Code

Email Phone Type Phone #
 Cell  Home  Work
Emergency Contact Information: (optional)
Email Name Phone Type Phone #
 Cell  Home  Work

C. Out of State Conversion (Skip if not converting from out of state)

Driver’s License, Learner’s Permit or ID Card # Document Type Restriction(s) (if applicable)
 Learner’s Permit Driver’s License ID Card
Country State Issue Date (MM/DD/YYYY) Expiration Date (MM/DD/YYYY)

D. Required Demographic Information

Gender Eye Color Height (feet, inches)
 M F  Black Brown Gray Hazel Pink Blue Dichromatic Green Maroon Unknown

Register me (or keep me registered) as an Organ and Tissue Donor:  Yes  No For more information on organ and tissue donation, visit: NEDS.org.

Would you like to donate $2 to the Organ and Tissue Donor Registration Fund?  Yes No
(to be answered for renewal and replacement transactions only)

Military Status (documentation is required if checked – visit mass.gov/rmv for acceptable documents)
What military branch?
 If you are a veteran of the U.S. Armed Forces, do you
 Are you an active duty member?
want the word “VETERAN” printed on your ID?

E. CDL Downgrade (if applicable)

CDL Downgrade: I understand that my CDL will be downgraded to a Class D, M,
or D/M license and I authorize the RMV to process this transaction.

Applicant Signature: ________________________________________________

p.1 LIC100_0119

DO NOT INCLUDE THIS PAGE IN YOUR PACKAGE

 Driver’s License, Learner’s Permit
or ID Card Application
(Passenger (Class D), Motorcycle (Class M), Class D/M, or Massachusetts Identification Card)

A. Service Type
■
1. Type: REAL ID  Standard ID

■
2. Document to Issue: Learner’s Permit  Driver’s License  Massachusetts ID Card

3. Class of Learner’s Permit/License (if applicable): Passenger (Class D) Motorcycle (Class M) Both (Class D/M)

■
4. Service Type: New Renewal Replacement Out-of-State Conversion Reinstatement CDL Downgrade
 Change of Information (Enter new information in applicable fields): Name Address DOB Gender Height Eye Color

B. Applicant Information
Last Name (If you’re getting a REAL ID, provide your full legal name) First Name Middle Name Suffix
Hurley Joseph
Current Massachusetts Learner’s Permit or Driver’s License # (if applicable) Date of Birth (MM/DD/YYYY)
S 6 0 6 9 6 8 8 3 11/20/1982
What is your Social Security Number? If you do not have a Social Security Number, you will need an SSA Denial notice & Foreign Passport.
0 2 4 6 4 8 2 5 2 Foreign Passport #
Residential Address (Where you actually reside)

Street 910 summer st Apt. # City Bridgewater State MA Zip Code 02324
Mailing Address  (same as above)

Street Apt. # City State Zip Code

Email Phone Type Phone #
[email protected]  Cell  Home  Work 5082507927
Emergency Contact Information: (optional)
Email Name Phone Type Phone #
 Cell  Home  Work

C. Out of State Conversion (Skip if not converting from out of state)

Driver’s License, Learner’s Permit or ID Card # Document Type Restriction(s) (if applicable)
 Learner’s Permit Driver’s License ID Card
Country State Issue Date (MM/DD/YYYY) Expiration Date (MM/DD/YYYY)

D. Required Demographic Information

Gender Eye Color Height (feet, inches)

■
 M F ■
 Black Brown Gray Hazel Pink Blue Dichromatic Green Maroon Unknown 5 feet 10 inches
Register me (or keep me registered) as an Organ and Tissue Donor:
■
 Yes  No For more information on organ and tissue donation, visit: NEDS.org.

Would you like to donate $2 to the Organ and Tissue Donor Registration Fund?
(to be answered for renewal and replacement transactions only)
■
 Yes No

Military Status (documentation is required if checked – visit mass.gov/rmv for acceptable documents)
What military branch?
 If you are a veteran of the U.S. Armed Forces, do you
 Are you an active duty member?
want the word “VETERAN” printed on your ID?

E. CDL Downgrade (if applicable)

CDL Downgrade: I understand that my CDL will be downgraded to a Class D, M,
or D/M license and I authorize the RMV to process this transaction.

Applicant Signature: ________________________________________________

p.1 LIC100_0119
 F. Voter Registration
To vote in Massachusetts you must be: A U.S. CITIZEN, a resident of Massachusetts and at least 18 years old on or before the next election in your
city or town, which could be a town meeting, city or town preliminary, city or town election, state primary, state election, special state primary, special
state election, or special city or town election.
1. Do you want to register to vote?........................................................................................................................................................  Yes  No
• Check “Yes” if you want to register to vote, or you are changing your name or address and want to be registered to vote with this new information.
• If you answered “Yes,” complete question #2 and read the Affirmation Section below.
• Check “No” if you are currently registered to vote and do not want to change your voter registration.
2. Are you a citizen of the United States of America?............................................................................................................................  Yes  No
NOTE: If you answered “no” to this question, do not complete question #3. You are not eligible to register to vote at this time.
3. Please indicate party enrollment or political designation (check one).  Democratic  Republican  Libertarian  Green-Rainbow
 No Party (unenrolled)  Political Designation (not a political party) (Print desired designation): ____________________________________
PLEASE ASK THE LICENSE CLERK FOR YOUR VOTER REGISTRATION RECEIPT
AFFIRMATION TO BE READ BY APPLICANTS REGISTERING TO VOTE
I hereby swear (affirm) that I am the person named above, that the above information is true, that I AM A CITIZEN OF THE UNITED STATES, that I
am at least 16 years old and I understand that I must be 18 years old to be eligible to vote, that I am not a person under a guardianship which prohibits
my registering to vote, that I am not temporarily or permanently disqualified by law from voting because of corrupt practices in respect to elections, that
I am not currently incarcerated for a felony conviction, and that I consider this residence to be my home. Signed under the penalty of perjury.
Confidentiality of voter registration information: If you register to vote, the office at which you submit your application will remain confidential and
will be used only for voter registration purposes. If you decline to register to vote, the fact that you declined to register will remain confidential and will
be used only for voter registration purposes.
Penalty for illegal voter registration: Fine of not more than $10,000 or imprisonment for not more than five years or both (M.G.L., Chap. 56, Section 8).

G. Mandatory Questions
1. In the past 10 years, have you held any class of license, in any other state, country or jurisdiction? .....................................................  Yes  No ■
If yes, where? (Country/State) _______________________________ What credential class? _______________ What credential #? ____________

List any current license/permit also: _________________________________________________________________________________________

You may use additional paper if necessary.
2. Do you have a cognitive, neurologic, physical or any other impairment that may affect.........................................................................  Yes  No
your functional ability to operate a motor vehicle safely?
■
3. Are you currently taking any medication that may affect your ability to safely operate a motor vehicle? ............................................... ■
 Yes  No

4. Is your license or RIGHT to operate suspended, revoked, canceled, withdrawn, or disqualified here or................................................  Yes ■
 No
in another state, country or jurisdiction?

H. Parent/Guardian Consent for Applicants under the age of 18

(Information & Certification of Person Providing Consent)

If the person giving consent IS NOT a parent, proper documentation of authority must be shown.
I hereby certify I am: (check one) parent  legal guardian  Department of Children and Families  boarding school headmaster
of the above-named applicant who is less than 18 years of age, but not less than 16 years of age, if applying for a Learner’s Permit or Driver’s License
OR who is less than 18 years of age, but not less than 14 years of age, if applying for an ID card, and that my consent is given as required by M.G.L.
Chap. 90, Section 8 for the issuance of a Driver’s License; or as required by M.G.L. Chap. 90, Section 8B for a Learner’s Permit; or by M.G.L. Chap.
90, Section 8E for an Identification Card (ID). False certification is punishable by fine, imprisonment, or both (M.G.L. Chap. 90, Section 24B).

Parent/Guardian’s Address: _________________________________________________________________________________________________

Parent/Guardian’s Signature:_____________________________________________________________

I. Certification and Signature of Applicant (application not complete without signature)

I have reviewed this completed Application Form, including the Voter Registration Section, and hereby apply for a Learner’s Permit/Driver’s License
or an ID card and swear (affirm), under the penalties of perjury, that the information I have provided is true and correct.
I am aware that false statements are punishable by fine, imprisonment, or both under M.G.L. Chapter 90, Section 24B.
12/11/2019
Signature:__________________________________________________________ Date: __________________________

The Registrar reserves the right to cancel, revoke, or recall, any learner’s
permit, driver’s license, or ID card if it is determined that the applicant was
not qualified for such learner’s permit, driver’s license, or ID card.

RMV Use Only

Date:___________________________ Clerk Initials:__________________

p.2 LIC100_0119
 5

DO NOT INCLUDE THIS PAGE IN YOUR PACKAGE