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California Department of Motor Vehicles
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Form Information

Forms


Commercial Employer Pull Notice Requester Account Notice of Change (INF 4)

The INF 4 form:

  • is used when any changes occur to the company name, address, phone number, or contact person of an employer enrolled in EPN
  • must be submitted by the employer within 10 days of occurrence to avoid delays in receiving the Driver Record Printouts (DL 414), or possible closure due to the DMV receiving returned unclaimed mail.

Note: Any changes of ownership, including most mergers, require closing the existing EPN Account and establishing a new account with the new owner/employer's information.

EPN cannot accept forms submitted by e-mail at this time. Forms must be:

  • printed and completed by hand, or
  • printed and completed by typewriter, or
  • completed on-line and printed.

Please mail the completed form to the following address:

Department of Motor Vehicles
EPN Program - H265
P. O. Box 944231
Sacramento, California 94244-2310

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Commercial Employer Pull Notice Enrollment or Deletion of Drivers (INF 1100)

The INF 1100 form:

  • is used when an employer needs to add California licensed drivers or delete any driver currently enrolled in the EPN Program.
  • must contain the employer's EPN requester code number issued by the Department of Motor Vehicles.
  • provides a "Remarks" column for employers to add information to the "Driver Record Report" (DL 414), for example; terminal site, vehicle plate/VIN number, or employee identification number.
  • upon enrollment of a driver, will generate a "Driver Record Report".

EPN cannot accept forms submitted by e-mail at this time. Forms must be:

  • printed and completed by hand, or
  • printed and completed by typewriter, or
  • completed on-line and printed.

Please mail the completed form to the following address:

Department of Motor Vehicles
EPN Program - H265
P. O. Box 944231
Sacramento, California 94244-2310

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Authorization for Release of Driver Record Information (INF 1101)

The INF 1101 form:

  • is used when a employer wishes to enroll a non-mandated driver into the Employer Pull Notice (EPN) Program.
  • must be completed by both the non-mandated driver as well as the employer.
  • must be completed and retained at the employer's principal place of business.
  • must be available upon request to DMV staff.

Forms must be:

  • printed and completed by hand, or
  • printed and completed by typewriter, or
  • completed on-line and printed.

Do not return this form to DMV.

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Commercial Employer Pull Notice Enrollment of Out of State Licensed Drivers (INF 1102)

The INF 1102 form:

  • is used when an employer needs to add an out-of-state licensed driver to the EPN program.
  • is not used to delete drivers.
  • will provide information on the "Driver Record Report" containing only information from the California DMV database, which may include prior record information.
  • requires that all fields for each driver be completed for processing.

EPN cannot accept forms submitted by e-mail at this time. Forms must be:

  • printed and completed by hand, or
  • printed and completed by typewriter, or
  • completed on-line and printed.

Please mail the completed form to the following address:

Department of Motor Vehicles
EPN Program - H265
P. O. Box 944231
Sacramento, California 94244-2310

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Government Employer Pull Notice (INF 1103)

The INF 1103 form:

  • is used when a government employer needs to add California licensed drivers or delete any driver currently enrolled in the Employer Pull Notice (EPN) Program.
  • must contain the government employer's EPN requester code number issued by the Department of Motor Vehicles.
  • provides a "Remarks" column for employers to add information to the "Driver Record Report", for example; terminal site, vehicle plate/VIN number, or employee identification number.
  • upon enrollment of a driver, will generate a "Driver Record Report".
  • must be submitted to the address on the form for processing.

EPN cannot accept forms submitted by e-mail at this time. Forms must be:

  • printed and completed by hand, or
  • printed and completed by typewriter, or
  • completed on-line and printed.

Please mail the completed form to the following address:

Department of Motor Vehicles
EPN Program - H265
P. O. Box 944231
Sacramento, California 94244-2310

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Government Employer Pull Notice Driver Licensed Out-of-state Additions (INF 1103A)

The INF 1103A form:

  • is used when a government employer needs to add an out-of-state licensed driver who drives in California to the EPN Program.
  • will provide information on the "Driver Record Report" containing only information from the California DMV database, which may include prior record information.
  • requires that all fields for each driver be completed for processing.

EPN cannot accept forms submitted by e-mail at this time. Forms must be:

  • printed and completed by hand, or
  • printed and completed by typewriter, or
  • completed on-line and printed.

Please mail the completed form to the following address:

Department of Motor Vehicles
EPN Program - H265
P. O. Box 944231
Sacramento, California 94244-2310

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Application for Employer Pull Notice Account (INF 1104)

The INF 1104 form:

  • is used when a commercial employer wishes to enroll in the EPN Program.
  • requires that all fields be completed to avoid processing delays.
  • must be printed in ink, completed by typewriter, or filled in online then printed.

EPN cannot accept forms submitted by e-mail at this time. Forms must be:

  • printed and completed by hand, or
  • printed and completed by typewriter, or
  • completed on-line and printed.

Please mail the completed form to the following address:

Department of Motor Vehicles
EPN Program - H265
P. O. Box 944231
Sacramento, California 94244-2310

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Pull Notice Contract (INF 1105)

The INF 1105 form:

  • contract between the department and the commercial employer.
  • must be completed and submitted to the department in duplicate.
  • must be submitted with the Application for "Employer Pull Notice Account"
    (INF 1104).

EPN cannot accept forms submitted by e-mail at this time. Forms must be:

  • printed and completed by hand, or
  • printed and completed by typewriter, or
  • completed on-line and printed.

Please mail the completed form to the following address:

Department of Motor Vehicles
EPN Program - H265
P. O. Box 944231
Sacramento, California 94244-2310


Employer Pull Notice Program Enrollment Packet (INF 1250A)

The INF 1250A packet:

  • contains all forms required for enrollment into the Employer Pull Notice Program.
  • must be submitted with 2 copies each of the INF 1104 and INF 1105 forms containing original signatures.

Note: Any changes of ownership, including most mergers, require closing the existing EPN Account and establishing a new account with the new owner/employer's information. EPN cannot accept forms submitted by e-mail at this time. Forms must be:

  • printed and completed by hand, or
  • printed and completed by typewriter, or
  • completed on-line and printed.

Please mail the completed form to the following address:

Department of Motor Vehicles
EPN Program - H265
P. O. Box 944231
Sacramento, California 94244-2310

Back to Top of Page