ID & VOTING APPENDIX

ID & VOTING APPENDIX

CDPH Application for Certified Copy of Birth Record – PG. 78A Listing of Vital Statistics Office Phone Numbers for Each State – PG. 82Application for Replacement Naturalization/Citizenship Document, Form N-565 – PG. 91Application for a Social Security Card, Form SS-5 – PG. 94Franchise Tax Board, Identity Theft Affidavit– PG. 96Verification for Reduced Fee Identification Card, Form DL 932 – PG. 99Court-Ordered Debt Payment Instructions – PG. 102
A Full List of Acceptable Identity & Residency Verification Documents for AB 60 “Undocumented Person” California Driver License – PG. 103A Full List of Countries that Issue Consular Identification Cards (CIDs) – PG. 109Notice of Motion for Judicial Review of License Denial, Form FL-670 – PG. 110 U.S. Passport Renewal Application, Form DS-82 – PG.  113Status Information Letter for Selective Service System – PG. 120
Appendix A
CDPH Application for Certified Copy of Birth Record

See next page.

Macintosh HD:Users:mila:Downloads:VS111-v.pdf

Macintosh HD:Users:mila:Downloads:VS111-2.pdf

Macintosh HD:Users:mila:Downloads:VS111-3.pdf

Appendix B
A Listing of Vital Statistics Office Phone Numbers for Each State

For people born outside of California in the U.S., this Appendix provides a chart that contact information for the Vital Statistics Office (also called Vital Records Office) in each state. However, because these addresses and phone numbers are subject to change, you should check with the CDC for the most up-to-date information. You can:

    Visit the CDC website at http://www.cdc.gov/nchs/w2w.htm
    Call the CDC directly by phone at 1-800-CDC-INFO (1-800-232-4636)
    OR
    Write to the CDC at:

Centers for Disease Control and Prevention1600 Clifton RoadAtlanta, GA 30329-4027

Once you locate the Vital Statistics Office in the state where you were born, let them know that you are trying to get an authorized certified copy of your birth certificate. Ask (1) what their procedures are; (2) what you need to send the Vital Statistics Office; and (3) the cost.

IMPORTANT NOTE IF YOU ONLY HAVE A PRISON/JAIL ID CARD: If the only identification (ID) that you currently have is a valid prison ID card, it may be enough in some states to request your birth certificate. First, call the state where you were born, follow the instructions to be connected to an operator, and confirm what document you need to provide to get your certified birth certificate. If you only have a prison ID card, here are a few examples of what states will ask you to provide in addition to that card:

The point is, it’s best to call ahead and ask!

CONTACT INFORMATION OF VITAL STATISTICS OFFICES IN EVERY STATE

STATE

MAILINGADDRESS

PHONE

COST FOR A COPY OF BIRTH CERTIFICATE, AND WHO TO ADDRESS THE CHECK TO

Alabama

Alabama Vital Records

P.O. Box 5625


Montgomery, AL 36103-5625

(334) 206-5418

$15.00 (Additional copies $6.00 each, and to expedite a request is an additional $15.00)

Check or money order should be made payable to “State Board of Health”

Alaska

Dept. of Health and Social Services

Bureau of Vital Statistics

5441 Commercial Blvd.

Juneau, AK 99801

(907) 465-3391

$30.00 (Additional copies are $25.00 each)

Personal check or money order should be made payable to “Bureau of Vital Statistics”

SPECIAL NOTES:

You must inclue a copy of government-issued picture ID with your application (e.g., Identification Card, Drivers License, a Prison/Jail ID Card, etc.)

While copying/scanning picture ID, enlarge the copy and lighten the picture on the computer or printer as much as possible to be sure that it is clear and readable when sent to Alaska’s Bureau of Vital Statistics.

REQUIRED: After copying your picture ID, you must sign the paper you submit along with the application itself.

American Samoa

American Samoa Government Dept. of Homeland

Security
Office of Vital Statistics

P.O. Box 6894


Pago Pago, AS 96799

(684) 633- 1405/1406. For Health Information Office, Health and Vital Statistics call (684) 633-4606/2262

$5.00

Money order should be made payable to “The Office of Vital Statistics/ASG.” Personal checks are not accepted.

Arizona

Office of Vital Records Arizona Dept. of

Health Services

P.O. Box 3887

Phoenix, AZ 85030-3887

(602) 364-1300

$20.00

Cashier’s checks and money orders must be for the exact amount and made payable to “Office of Vital Records”

SPECIAL NOTES: Acceptable payment methods are cashier’s check, money order, Visa or MasterCard. If you pay by credit/debit card, you must include the full number and expiration date on your application.

Arkansas

Arkansas Dept. of Health

4815 West Markham St.

Little Rock, AR 72205

(501) 661-2336

$12.00 ($10.00 for each additional copy)

Personal check or money order should be made payable to “Arkansas Dept. of Health”

California

CA Dept. of Public Health—Vital Records

MS: 5103


P.O. Box 997410

Sacramento, CA 95899-7410

(916) 445-2684

$25.00

A personal check or money order should be made payable to “CDPH Vital Records”

Canal Zone

Vital Records Section Passport Services
U.S. Dept. of State

1111 19th St. NW, Suite 510

Washington, DC 20522-1705

(202) 955-0307

$30.00 (Additional copies of the same record requested at the same time are $20.00 each.

Personal check or money order must be signed, dated and made payable to “U.S. Dept. of State”

Colorado

Vital Records Section
CO Dept. of Public Health and Environment

4300 Cherry Creek Drive South HSVRD-VS-A1

Denver, CO 80246-1530

(303) 692- 2200

$17.75 (Additional copies of the same birth record ordered at the same time are $10.00 each.)

Personal check or money order should be made payable to “Vital Records Section”

Connecticut

CT Dept. of Public Health

410 Capitol Ave., MS #11 VRS

Hartford, CT 06134

(860) 509-7897

$30.00

Requests sent to the State Vital Records Office require a postal money order made payable to the “Treasurer, State of Connecticut”

Delaware

Office of Vital Statistics Division of Public Health 417 Federal St.

Dover, DE 19901

(302) 744-4549

$25.00

Personal check or money order should be made payable to “Office of Vital Statistics”

District of Colombia

Vital Records Division

899 North Capitol St. NE, First Floor

Washington, DC 20002

(202) 671- 5000

$23.0

Personal check or money order should be made payable to “DC Treasurer”

Florida

Dept. of Health
Bureau of Vital Statistics

P.O. Box 210
1217 Pearl St. (Zip 32202)

Jacksonville, FL 32231-0042

(904) 359-6900

$9.00

Personal check or money order should be made payable to “Bureau of Vital Statistics”

Georgia

MAIL-IN REQUEST:

State Vital Records Office

2600 Skyland Dr., NE

Atlanta, GA 30319

IN-PERSON REQUEST:

There are 159 counties in Georgia. You can go to the office in the county where you were born. If you aren’t sure, call the phone number listed to the right.

(404) 679-4702

Call this phone number if you need the mailing address or telephone of a specific county’s Vital Records office in Georgia.

$25.00 (Additional copies of the same record ordered at the same time are $5.00.)

A certified check or money order should be made payable to “Vital Records Services”

SPECIAL NOTES: All requests for vital records include the signature and photocopy picture ID of the requestor and the proper fee.

Guam

Office of Vital Statistics

P.O. Box 2816

Hagatna, Guam 96932

(671) 735-7292

$5.00

Money order should be made payable to “Treasurer of Guam”

Hawaii

State Dept. of Health Office of Health Status

Monitoring Issuance/Vital Statistics Section

P.O. Box 3378

Honolulu, HI 96801

(808) 586-4533

$10.00 (Additional copies ordered at the same time are $4.00 each.)

Cashiers check, certified check, or money order should be made payable to “State Dept. of Health”

Idaho

Vital Records Unit
Bureau of Vital Records and

Health Statistics

P.O. Box 83720

Boise, ID 83720-0036

(208) 334- 5988

$13.00

Personal check or money order should be made payable to “Idaho Vital Records”

Illinois

Division of Vital Records Illinois Dept. of Public

Health
925 E Ridgely Ave.

Springfield, IL 62702

(217) 782-6553

$15.00 (Additional certifications of the same record ordered at the same time are $2.00 each.)

Money orders, certified checks, or personal checks should be made payable to “Illinois Dept. of Public Health”

Indiana

Vital Records
Indiana State Dept. of Health

P.O. Box 7125


Indianapolis, IN 46206-7125

(317) 233-2700

$10.00(Additional copies of the same birth record ordered at the same time are $4.00 each.)

Personal check or money order should be made payable to “Indiana State Dept. of Health”

Iowa

Iowa Dept. of Public Health

Bureau of Vital Records Lucas Office Building
1st Floor
321 East 12th St.

Des Moines, IA 50319-0075

(515) 281-4944

$15.00

Personal check or money order should be made payable to “Iowa Dept. of Public Health”

Kansas

Office of Vital Statistics, Curtis State Office Building 1000 SW Jackson St., Suite 120

Topeka, Kansas 66612-2221

(785) 296-1400

$15.00(Additional copies of the same record ordered at the same time are $15.00 each.)

Personal check or money order should be made payable to “Vital Statistics”

Kentucky

Office of Vital Statistics

Dept. for Public Health, Cabinet for Health and Family Services


275 East Main St. 1E-A

Frankfort, KY 40621-0001

(502) 564- 4212

$10.00

Personal check or money order should be made payable to “Kentucky State Treasurer”

Louisiana

Office of Public Health Vital Records Registry

P.O. Box 60630

New Orleans, LA 70160

(504) 593-5100

Fax: (504) 568-8716

Louisiana (LA) Birth Certificate Types:

Birth Long: (SUGGESTED, CERTIFIED) A certified birth certificate that can typically be used for travel, passport, proof of citizenship, social security, driver's license, school registration, personal identification and other legal purposes. Birth Certificates are available for events that occurred in the State of Louisiana within the last 100 years.

First Long Copy: $15.00; Additional Copies: $15.00

Birth Short—Card: The Birth Short—Card is a wallet size version of the Birth Certificate that can be used for INFORMATIONAL PURPOSES ONLY. THIS CANNOT BE USED TO OBTAIN A PASSPORT, DRIVER'S LICENSE OR TRAVEL.

First Copy: $9.00; Additional Copies: $9.00

Checks made payable to “Louisiana Vital Records”

SPECIAL NOTES: Walk-in services only accept cash, check, or money order payment (no credit/debit cards).

Maine

Maine Center for Disease Control and Prevention

11 State House Station
220 Capitol St.


Augusta, Maine 04333-0011

(207) 287-3181, or toll-free at 1-888-664-949

Certified $15.00. Non-Certified $10.00.

(Additional copies of same record ordered at same time are $6.00 each.)

Personal check or money order should be made payable to “Treasurer, State of Maine”

Maryland

Division of Vital Records Dept. of Health and

Mental Hygiene
6550 Reisterstown Road P.O. Box 68760
Baltimore, MD 21215-0036

(410) 260-6400

$24.00

Personal check or money order should be made payable to “Division of Vital Records”

Massachusetts

Registry of Vital Records and Statistics

150 Mount Vernon St.,
1st Floor

Dorchester, MA 02125-3105

If your birth certificate is from the year 1920 or earlier, CALL

(617) 727-2816

If your birth certificate is from the year 1921 or later, CALL

(617) 740-2600

$20.00 (In-person Request)

$32.00 (Mail-In request)

Additional $3.00 for Birth Certificated from year 1920 or earlier

Personal check or money order should be made payable to “Commonwealth of Massachusetts”

SPECIAL NOTES: State office has no records previous to 1921. For earlier records, write to The Massachusetts Archives at Columbia Point, 220 Morrissey Blvd., Boston, MA 02125 (617) 727-2816.

Michigan

Vital Records Request

P.O. Box 30721

Lansing, MI 48909

To request an application, call the recorded message at (517) 335-8656 to leave your name and mailing address with type of application needed. To speak to a customer service representative call (517)- 335-8666 and press option #4

$34.00 (Only $14.00 for Senior Citizens age 65+ if requesting their own birth record.)

Rush fee additional $12.00.

Additional copies of any record ordered at the same time are $16.00 each.)

Personal check or money order should be made payable to “State of Michigan”

Minnesota

Minnesota Dept. of Health Central Cashiering –
Vital Records

P.O. Box 64499

St. Paul, MN 55164

(651) 201-5970

$26.00 (Additional copies of the birth record when ordered at the same time are $19.00.)

Personal check or money order should be made payable to Minnesota Dept. of Health.

Mississippi

Mississippi Vital Records State Dept. of Health P.O. Box 1700

Jackson, MS 39215-1700

To verify current fees, the telephone number is (601) 576-7981. A recorded message may be reached on (601) 576-7450

$15.00 (Additional copies of same record ordered at the same time are $5.00 each.)

Personal check, bank or postal money order or bank cashier’s check are accepted and should be made payable to “Mississippi State Dept. of Health”

Missouri

Missouri Dept. of Health and Senior Services

Bureau of Vital Records

930 Wildwood

P.O. Box 570

Jefferson City, MO 65102-0570

(573) 751-6387

$15.00(Copies of these records are $15.00 each)

Personal check or money order should be made payable to “Missouri Dept. of Health and Senior Services”

SPECIAL NOTES: Please include a legal size self- addressed stamped envelope.

Montana

Office of Vital Statistics,

MT Dept. of Public Health and Human Services

111 N Sanders, Rm. 6

P.O. Box 4210 Helena, MT 59604

(406) 444- 2685

$12.00

(Additional copies of the same record requested at the same time are $5.00.)

Personal check or money order should be made payable to “Montana Vital Records”

Nebraska

Nebraska Vital Records

P.O. Box 95065

Lincoln, NE 68509-5065

(402) 471- 2871

$17.00

Personal check or money order should be made payable to “Nebraska Vital Records”

Nevada

Office of Vital Records

4150 Technology Way, Suite 104

Carson City, NV 89706

(775) 684- 4242

$20.00

Personal check or money order should be made payable to “Office of Vital Records”

New Hampshire

Division of Vital Records Administration—

Archives Building


71 South Fruit St.

Concord, NH 03301-2410

(603) 271-4651

$15.00

Personal check or money should be made payable to “Treasurer, State of New Hampshire”

New Jersey

New Jersey Dept. of Health
Office of Vital Statistics and Registry


P.O. Box 370

Trenton, NJ 08625-0370

TOLL FREE (866) 649-8726

(OR visit online at http://www.state.nj.us/health/vital for up-to-date information on ordering)

$25.00 (Additional copies of the same record ordered at the same time are $2.00 each.)

SPECIAL NOTES: For information on Express Mail or In persons order visit http://www.state.nj.us/health/vital/contact.shtml

New Mexico

NM Vital Records

P.O. Box 25767

Albuquerque, NM 87125

TOLL FREE

(866) 534-0051

$10.00

Personal check or money order should be made payable to “NM Vital Records”

New York

Certification Unit Vital Records Section, 2nd Floor

800 North Pearl St.

Menands, NY 12204

1-855-322-1022

$30.00

Personal check or money order should be made payable to “New York State Dept. of Health”

New York City

NYC Health Department Office of Vital Records

125 Worth St., CN4, Rm. 133

New York, NY 10013

(212) 639-9675

$15.00 (Additional Copies $15.00)

SPECIAL NOTES:

The office has birth records for people who were born and/or died in the five boroughs of New York City: Brooklyn, the Bronx, Manhattan, Queens, or Staten Island.

Birth records issued before 1910 and death records issued before 1949 must be ordered through the Municipal Archives.

For more information please visit: http://www.nyc.gov/html/doh/html/services/vr-order-other.shtmlor write to Dept. of Records and Information Services, 31 Chambers St., New York, NY 10007.

North Carolina

NC Vital Records

1903 Mail Service Center

Raleigh, NC 27699-1903

(919) 733- 3000

$24.00

Business or certified check or money order should be made payable to “NC Vital Records”

North Dakota

ND Dept. of Health Division of Vital Records

600 East Blvd. Ave., Dept. 301


Bismarck, ND 58505-0200

(701) 328- 2360

$7.00(Additional copies of birth records are $4.00)

Personal check or money order should be made payable to “ND Dept. of Health”

North Mariana Islands

Commonwealth Healthcare Corporation

Vital Statistics Office

P.O. Box 500409

Saipan, MP 96950

(670) 236-8717 or (670) 236-8702

$20.00

Money order or bank cashiers check should be made payable to “Commonwealth Healthcare Corporation”

Ohio

Vital Statistics
Ohio Dept. of Health

P.O. Box 15098

Columbus, OH 43215-0098

(614) 466- 2531

$21.50

Personal check or money order should be made payable to “Treasury, State of Ohio”

Oklahoma

Vital Records Service
Oklahoma State Dept. of Health

P.O. Box 53551

Oklahoma City, OK 73152

(405) 271-4040

$15.00(Additional Copies $ 15.00 each)

Personal check or money order should be made payable to “OSDH”

Oregon

Oregon Vital Records

P.O. Box 14050

Portland, OR 97293-0050

(971) 673-1190

$20.00(Additional copies of the same record ordered at the same time are $15.00 each.)

Personal check or money order should be made payable to “OHA/Vital Records”

Pennsylvania

Division of Vital Records

ATTN: Birth Unit

101 South Mercer St., Room 401

P.O. Box 1528
New Castle, PA 16103

(724) 656-3100

$20.00

Personal check or money order should be made payable to “Vital Records”

Puerto Rico

Dept. of Health Demographic Registry

P.O. Box 11854

Fernández Juncos Station

San Juan, PR 00910

(787) 765-2929 Ext. 6131

$5.00 ($4.00 each additional copy requested on the same application. Registrants over 60 years of age and Veterans of the United States Armed Forces can obtain copies of their birth records free of charge.)

Payment method via money orders, which should be made payable to the “Secretary of Treasury”

SPECIAL NOTES: Maximum three (3) copies per registrant per year. Beneficiaries of a Veteran of the United States Armed Forces can obtain copies of their death records free of charge (widow or children under 21 years of age).

Rhode Island

RI Dept. of Health Office of Vital Records, Room 101

3 Capitol Hill

Providence, RI 02908-5097

To verify current fees after office hours, the telephone number is (401) 222-2811.

To verify current fees and general information during office hours, please call the Health Hot Line at (401) 222-5960

$20.00(Additional copies of the same record ordered at the same time are $15.00 each.)

Personal check or money order should be made payable to “Rhode Island General Treasurer”

South Carolina

Office of Vital Records, SCDHEC

2600 Bull St.

Columbia, SC 29201

(803) 898-3630

$12.00(Additional copies of the same birth records ordered at the same time of certification are $3.00 each.)

Acceptable method of payment is a money order or cashiers check made payable to “SCDHEC- Vital Records.”

South Dakota

Vital Records,
State Dept. of Health

207 E Missouri Ave, Suite 1-A

Pierre, SD 57501

(605) 773-4961

$15.00

Personal check or money order should be made payable to “South Dakota Dept. of Health.”

Tennessee

Tennessee Vital Records Central Services Building 4215th Ave.

North Nashville, TN 37243

(615) 741- 1763

Long term- $15.00

Short term- $ 8.00

(Additional copies of the same birth, marriage, or divorce record requested at the same time are $5.00 each.)

Personal check or money order should be made payable to “Tennessee Vital Records”

Texas

Texas Vital Records Dept. of State Health

Services

P.O. Box 12040

Austin, TX 78711-2040

(512) 776- 7111

$22.00 (Additional copies of the birth record ordered at same time are $22.00 each.

Mail-in requests must be made by personal check or money order made payable to DSHS.

Utah

Certification Unit

Office of Vital Records

P.O. Box 141012

Salt Lake City, UT 84114-1012

(801) 538-6105

$20.00 (Additional copies, when requested at the same time, are $8.00 each.)

Personal check or money order should be made payable to “Vital Records”

SPECIAL NOTES:

ID is now required to purchase a Utah Birth Certificate.

Mailed request must include an enlarged and easily identifiable photocopy of the front and back of your ID. If no proofs are enclosed, your application will be returned.

Vermont

VT Dept. of Health Vital Records Section

P.O. Box 70
108 Cherry St.

Burlington, VT 05402-0070

(802) 863-7275

$10.00.

Personal check or money order should be made payable to “Vermont Dept. of Health”

Virginia

Division of Vital Records

P.O. Box 1000

Richmond, VA 23218-1000

(804) 662-6200

$12.00

Personal check or money order should be made payable to “ State Health Department”

SPECIAL NOTES: Must submit a photocopy of their ID.

Virgin Islands

Dept. of Health
Vital Statistics,

Charles Harwood Memorial Hospital

St. Croix, VI 00820

(340) 774-9000 ext. 4685 or 4686

$15.00 (mail requests). $12.00 (in person).

Money order for birth records should be made payable to “Department of Health”

SPECIAL NOTES: Personal checks are not accepted

Washington

Center for Health Statistics

Department of Health

P.O. Box 9709

Olympia, WA 98504-7814

(360) 236- 4300

$20.00(For Expedited Delivery must add Express Mail, an additional $18.30)

Personal check or money order should be made payable to “Department of Health”

West Virginia

Vital Registration Office, Room 165

350 Capitol St.

Charleston, WV 25301-3701

(304) 558-2931

VitalChek Phone: (877) 448-3953

Fax: (866) 870-8723

$12.00(By Mail or In Person)

$30.50 + shipping (By Phone, Internet, or Fax) (Non-Rush Fee Charged by VitalChek)

$35.50 + shipping (Rush Fee Charged by VitalChek)

SPECIAL NOTES: Can order in person, by mail, by phone, Internet or fax (Credit Card/ Debit Card Only). Personal check or money order should be made payable to “Vital Registration”

Wisconsin

WI Vital Records Office

1 West Wilson St. P.O. Box 309

Madison, WI 53701-0309

For 24/7 automated assistance, call (608) 266-1371.

If you want to talk to a live person, call the service counter 8:00 A.M. to 4:15 P.M. (Central Time),

Monday through Friday at (608) 266-1373

$20.00 (Additional copies of the same record ordered at the same time are $3.00 each.)

Personal check or money order should be made payable to “State of Wisconsin Vital Records”

SPECIAL NOTES: A stamped, self addressed business size (#10) envelope should be include with the request. A copy of valid photo ID and a signature is required of the applicant.

Wyoming

Vital Statistics Services

Hathaway Building

2300 Capitol Avenue

Cheyenne, WY 82002

(307) 777-7591

$13.00

Personal check or money order should be made payable to “Vital Statistics Services"

SPECIAL NOTES: Please enclose a self-addressed, stamped envelope with the request. All personal checks are only accepted when: (1) the requestor is entitled to the record and the check in personalized and on the account of the person making the request; (2) third party or non-bank checks will not be processed.

Appendix C
Application for Replacement Naturalization/Citizenship Document, Form N-565

See next page.

Macintosh HD:Users:mila:Downloads:n-565-1.pdf

Macintosh HD:Users:mila:Downloads:n-565-2.pdf

Appendix D
Application for a Social Security Card, Form SS-5

See next page.

Macintosh HD:Users:mila:Downloads:n-565-5.pdf

Appendix E
Franchise Tax Board, Identity Theft Affidavit

See next page.

Appendix F
Verification for Reduced Fee Identification Card, Form DL 932

See next page for DMV Form DL-932, which a service provider must request from the DMC to get the appropriate DMV fee waiver verification forms to distribute to the people they serve.

PLEASE NOTE: You cannot access Forms DL 933 or 937 directly, which are the fee waiver forms that get turned into the DMV, but instead you must ask a nonprofit, social services or legal services agency to give you Form DL 933 or 937 filled out by their staff to take to the DMV.

Appendix G
Court-Ordered Debt Payment Instructions

Western Union is the only payment option to pay your court-ordered debt (COD) to the California Franchise Tax Board (FTB) offers to expedite the release of your driver license. If you have any other referring court-ordered liabilities, they must also be paid. To expedite (speed up) the release of your license:

    Call the referring office that placed the hold on your driver license and ask: “Does your office accept Western Union payment in full through the California Franchise Tax Board’s COD account to expedite the release of my license?” 
    If the answer is yes, then pay your COD account in full through Western Union and provide COD with the Western Union Money Transfer Control Number (MTCN).
    If the answer is no, ask the referring office if they accept other payment options to expedite the release.

WESTERN UNION

This service charges a fee.

    Go to Western Union—Send Money to pay online, in person, or by phone.
    Check Pay A Bill box
    Provide one of the following:
    Company name: CA Franchise Tax Board
    City code (no spaces): FranchiseTaxBoard
    Account number: Enter account number
    Attention: Court-Ordered Debt
    Amount: Enter payment amount
    Speed: Check Urgent box
    Once payment is complete, Western Union will give you a Money Transfer Control Number (MTCN).
    Call COD at 916.845.4064 and provide your MTCN to verify payment.

WEB PAY

Login to My COD Account online (https://www.ftb.ca.gov/online/Court_Ordered_Debt/index.asp) and go to “Pay Now.” Have the following information ready:

    Your COD account number
    Billing number on your COD notice
    Bank account holder last name
    Checking or savings account number and routing number

CREDIT CARD

This service charges a fee. Have the following information ready:

    Jurisdiction Code: 1584
    Payment type: Court-Ordered Debt Payment
    Your COD account number
    Billing number on your COD notice
    Pay online: Go to Official Payments—Make a Payment and select State Payments.
    Pay by phone: Call 800.272.9829 and select option 2 State Payments.

CHECK, MONEY ORDER, OR CASHIER’S CHECK

    Pay to Court-Ordered Debt Collections.
    Write your full name, account number, and billing number on your payment.
    Mail your payment and the top portion of your notice to: Court-Ordered Debt Collections, Franchise Tax Board, PO Box 1328, Rancho Cordova, CA 95741-1328
Appendix H
A Full List of Acceptable Identity & Residency Verification Documents for AB 60 “Undocumented Person” California Driver License

See next page.

Macintosh HD:Users:mila:Downloads:dmv.pdf

Macintosh HD:Users:mila:Downloads:dmv-2.pdf

Macintosh HD:Users:mila:Downloads:dmv-3.pdf

Macintosh HD:Users:mila:Downloads:dmv-4.pdf

Macintosh HD:Users:mila:Downloads:dmv-5.pdf

Appendix I
A Full List of Countries that Issue Consular Identification Cards (CIDs)

ARGENTINA: Matrícula Consular Argentina; Website: www.embassyofargentina.us/espanol/consuladosargentinoseneeuu/consuladosargentinoseneeuu.htm; Embassy Phone Number: (202) 238-6401

BRAZIL: Matrícula de Cidadão Brasileiro; Website: www.brasilemb.org/consulado/consular_jurisdictions.shtml; Embassy Phone Number: (202) 238-2828

COLOMBIA: Tarjeta de Registro Consular ; website: http://www.colombiaemb.org/opencms/opencms/consulates/consulates.html; Embassy Phone Number: (202) 387-8338

GUATEMALA: Tarjeta de Identificación Consular; Website: http://www.guatemala-embassy.org/main.php?parent_id=7&id_area=109; Embassy Phone Number: (202) 745-4952

GUINEA: Website: http://www.guineaembassy.com; Embassy Phone Number: (202) 986-4300

MALI: Carte d’Identité Consulaire; Website: http://www.maliembassy.us; Embassy Phone Number: (202) 332-2249; Consulate General of Mali in NY: (212) 737-4150

MEXICO: Mexican Matrícula Consular de Alta Seguridad; To find your consulate, visit http://www.embassyofmexico.org or http://directorio.gob.mx and click on Relaciones Exteriores, Embajadas y Consulados, Consulados de México en el extranjero. Embassy Phone Number: (202) 728-1600

SENEGAL: Carte Consulaire; Website: http://www.senegalembassy-us.org/enOurReps.htm; Embassy Phone Number: (202) 234-0540 or (202) 234-0541

DOMINICAN REPUBLIC: To find your local consulate, visit: http://www.domrep.org; Embassy Phone Number: (202) 332-6280

ECUADOR: Website: http://www.ecuador.us/info/consulate.htm; Embassy Phone Number: (202) 234-7200 ext. 224

EL SALVADOR: Website: http://www.elsalvador.org/home.nsf/infoconsular
Embassy Phone Number: (202) 265-9671

HONDURAS: Website: http://www.hondurasemb.org; Embassy Phone Number: (202) 737-2972

NIGERIA: Atlanta’s Nigeria Consulate Website: http://www.nigeria-consulate-atl.org; Phone Number: (770) 394-6261. New York’s Consulate Website: http://www.nigeria-consulate-ny.org; Phone Number (212) 850-2200; Embassy Phone Number: (202) 986-8400

PAKISTAN: Consulate General of Pakistan; Website: http://www.pakistanconsulateny.org; Embassy Phone Number: (212) 879-5800

PERU: Documento Nacional de Identificación, Peruvian consulates do not offer consular ID cards. However, their national ID may be accepted as form of ID by some institutions or companies. Website: http://www.consuladoperu.com/archivos/ jurisdicciones.com; Information Hotline: (800) 535-3953; Embassy Phone Number: (202) 833–9860/69

Appendix J
Notice of Motion for Judicial Review of License Denial, Form FL-670

See next page.

Appendix K
U.S. Passport Renewal Application, Form DS-82

See next page.

Macintosh HD:Users:mila:Downloads:passport-1.pdf

Macintosh HD:Users:mila:Downloads:passport2.pdf

Macintosh HD:Users:mila:Downloads:passport-3.pdf

Macintosh HD:Users:mila:Downloads:passport-4.pdf

Macintosh HD:Users:mila:Downloads:passport-5.pdf

Macintosh HD:Users:mila:Downloads:passport-6.pdfAppendix L
Status Information Letter for Selective Service System

See next page.

Macintosh HD:Users:mila:Downloads:status.pdf

Macintosh HD:Users:mila:Downloads:status2.pdf

Macintosh HD:Users:mila:Downloads:status3.pdf

Macintosh HD:Users:mila:Downloads:status4.pdf

Community Supervision:

  1. 303

    Arizona Dep’t of Hhttp://www.azdhs.gov/documents/licensing/vital-records/application-certificate-birth.pdf.

  2. 304

    https://public.health.oregon.gov/BirthDeathCertificates/GetVitalRecords/Pages/recordinformation.aspx