Driver Information

If you have taken a photo of your Driver’s License or New York ID card and imported it in Step 1, it should appear below. If your Driver’s License or New York ID Card doesn’t appear below, please take a photo of your Driver’s License or New York ID card and drag and drop into the box below

DRIVER — Enter the information for each driver EXACTLY as it appears on the driver license.

DRIVER OF VEHICLE 1

Driver License ID Number

State of License

Driver Name - Exactly as printed on license (Last, First, M.I.)

Address (include Number & Street)

Apt. Number

City or Town

State

Zip Code

Date of Birth

Sex

Number of
People in Vehicle

Public Property Damaged

Yes No

DRIVER OF VEHICLE 2

If you have taken a photo of the Driver’s License or New York ID Card of the Driver of Vehicle 2 and imported it in Step 1, it should appear below. If the Driver’s License or New York ID Card of the Driver of Vehicle 2 doesn’t appear below, please take a photo of the Driver’s License or New York ID Card of the Driver of Vehicle 2 and drag and drop into the box below