Customers fax this form to DMV for payment authorization 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the Applicant Information section. Enter your name, DMV customer number, daytime telephone number, mailing address, city, state, and ZIP code.
3. Next, provide Vehicle Information. Fill in the plate number, VIN, make, year, title number, and state of title.
4. In the Dealer Information section, select the application type and add any relevant comments.
5. For Payment Authorization, check the appropriate credit card option (MasterCard, Visa, Discover, or American Express). Enter the name on the card and daytime telephone number.
6. Input your credit card number and specify the amount to be charged. Don’t forget to include the expiration date and sign as the cardholder.
7. Finally, refer to the Transaction/Fax Information section to identify your applicable Work Center and fax your completed form to the provided number.

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