Real Estate Salesperson Application
5 DMV Consent Section — IMPORTANT Information Regarding Your Photo ID
The Department of State produces photo ID cards in cooperation with the NYS Department of Motor Vehicles (DMV). If you have a
current NYS Driver License or Non-Driver ID card, please provide your 9-digit DMV ID Number in the space provided below. Then
read the informed consent and sign this form. If you do not have a current NYS photo Driver License or Non-Driver ID card, please
have your photo taken at any nearby DMV office BEFORE you complete this application. For more details, refer to our enclosed notice,
"Request for Photo ID."
INFORMED CONSENT
I authorize the NYS Department of State and the NYS Department of Motor Vehicles (DMV) to produce an ID card bearing my DMV
photo. I understand that DMV will send this card to the address I maintain with the Department of State. I also understand that the
Department of State and DMV will use my DMV photo to produce all my subsequent ID Cards for as long as I maintain my
license/registration with the Department of State.
DMV ID # _______/_______/_______ - _______/_______/_______ - _______/_______/_______
X
Applicant's Signature
Date Signed
6 Association Statement — I am sponsoring this application in accordance with the Real Property Law, §441.1(d).
Broker License/Unique ID number
Broker Print Name
Broker Signature
Date
Please remember to include with this application any required
explanations and statements along with your application fee
(checks should be made payable to NYS Department of State).
It is important that you and/or your broker update any changes to your
business address through your online account so you can continue to receive
renewal notices and any other notifications pertinent to your license.
DOS-0022 (Rev. 6/08)
PAGE 3 OF 3