Employer Declaration for Ignition Interlock License 2026

1. Click ‘Get Form’ to open the Employer Declaration for Ignition Interlock License in our editor.
2. Begin by entering the applicant's name in the designated fields. Ensure you include the last name, first name, and middle initial as required.
3. Next, input the state of issuance for the driver's license and provide the driver's license number along with the date of birth.
4. Fill in the daytime telephone number of the employee to ensure easy communication.
5. Proceed to the employer section. Enter the company name and its corresponding telephone number.
6. Input the UBI number and complete the company’s street address, city, state, and zip code accurately.
7. Confirm that this employee is required to operate a vehicle during working hours by checking any necessary boxes or providing additional information if prompted.
8. Finally, have the employer print their name, sign where indicated, and date the form before submission.

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