Driver's License, Class State
(3)
Enter the number of the defendant's driver's license, including license class and state of issuance. If the defendant has no license
number,
enter "None". Do not leave it blank.
Defendant's Name
(4) Enter the defendant's FULL first, middle, last name, and suffix as it appears on the license, including hyphens. If a non-resident
license indicates only initials for the first or middle name, inquire as to given name and record the full name, not just the initial. Do
not write "none" if no middle name is given.
Defendant's Address
(5) Enter the defendant's street address, box number, apartment number, city, county, state, zip code, etc. Do not use "No Fixed
Address". Enter the CURRENT address if different from the address shown on the license. Inform the defendant to advise both the
District Court and the MVA of any change of address. (You may enter the address shown on the license, if different from the current
address, on the reverse side of the #1 copy together with defendant's name. Thus, the defendant will receive notices at two addresses.
For any name/address items listed on reverse side, check witness box to alert data entry clerks.)
Descriptive Information
(6) Enter the height, weight, race, ethnicity, sex, and birth date of the defendant. Record the FULL date of birth (month-day-year). If the
license indicates only a month and year for the birth, as some states do, inquire as to the day of birth. Without full date of birth, no
conviction information will be applied to driver record.
(7) Sex - Enter “Male,” “Female,” or “U” for unspecified / unknown / other. (May be indicated by an “X” on the license.)
(8) Race - Use the following codes for race and enter - 1 Black, African American - 2 White, Caucasian, Asiatic Indian, and Arab - 3
Asian, Native Hawaiian, Other Pacific Islander - 4 American Indian, Alaska Native - 5 Unknown/Other.
(9) Ethnicity - If the defendant is Hispanic, enter "Hispanic" in the Ethnicity field.
(10) Enter defendant's telephone number including area code.
Vehicle License No., State
(11) Enter the vehicle registration number and state of issuance. If the vehicle displays no registration, enter "none". Enter "Bicycle" if
appropriate.