Ignition Interlock Device (IID) Program Enrollment

To upload the PDF document you can either choose the 'Drag and drop' box or 'Browse' button below:

To Drag and Drop – You can drag files from your computer and then drop them into the box below.

Drag and drop your PDF document here.

-- OR --

Click on 'Browse' button below to choose the files from your computer.

Note: While dragging files you will see

and inside the green drop box where you can drop the file you will see

when you can drop the files.

Please provide details requested below:

Do you currently have a DC Driver License or DC Identification Card?:

Yes

No

State:

First Name:

No First Name

Last Name:

Date of Birth:

Last 5 digits of SSN:

Not Eligible for SSN

Driver License / Identification Card #:

Not Applicable

Document Information

Please upload all required documents listed below.

Note:
Documents should be in PDF format.
Maximum file size is limited to 4 MB

I declare under penalty of perjury that the uploaded document(s) and the information on the document(s) is true and correct and has not been altered in any manner. Any person(s) using a fictitious name or address and/or knowingly making any false statements on the uploaded document(s) is in violation of DC Law and subject to a fine of not more than $1,000 or 180 days imprisonment or both. (DC Official Code § 22-2405).

I have read and agreed to the above statement.

Document Information

Please review the sections below. Select button to confirm that the information is accurate. Select button to make changes.

Once you have verified that all information is accurate, you can select the ‘Confirm’ button to submit the request.

Customer Information

First Name:

Last Name:

Middle Name:

Suffix:

Date of Birth:

Gender:

Height:

Eye Color:

Email:

Mobile Phone Number:

Alternate Phone Number:

Address:

First Name:

Last Name:

Date of Birth:

DLN / ID Card:

Last 5 Digit SSN:

Email:

Mobile Phone Number:

Alternate Phone Number:

SR22 High Risk Insurance Information - Certificate of Financial Responsibility

Insurance Company:

Policy Number:

Policy Effective Date:

Policy Expiration Date:

Vehicle Information Details

Documents Provided

Payment Details

Non-Refundable Application Fee:

Payment Information

Total Fee:

Payment Method:

Name: *

Credit Card Type: *

Credit Card Number: *

Credit Card Verification Code: *

What is this?

Expires On Month: *

Year: *

Billing Street Address: *

Zip Code: *

Transaction has been completed successfully!

Your request for enrollment with the IID Program has been processed successfully. You will be notified via email within 3 business days regarding the status of your application. Please print receipt using the 'Print Receipt' button below.

Confirmation Details

Transaction Confirmation Number : 123456789

Fee Information

Non-Refundable Application Fee : $50.00

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