Forms

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After completing the required form, please mail it to the address on the form. EPN cannot accept completed forms submitted by e-mail at this time.

Call (916) 657-6346 for assistance regarding any forms or for general questions. Please call between the hours of 8 a.m. and 5 p.m. Monday through Friday (except State Holidays).

• Application for Employer Pull Notice Account (PDF) (INF 1104)
  More information about the INF 1104 from

• Pull Notice Contract (PDF) (INF 1105)
  More information about the INF 1105 form

• Commercial Employer Pull Notice Enrollment or Deletion of Drivers (PDF) (INF 1100)
  More information about the INF 1100 form

• Authorization for Release of Driver Record Information (PDF) (INF 1101)
  More information about the INF 1101 form

• Commercial Employer Pull Notice Enrollment of Out-of-State Licensed Drivers (PDF) (INF 1102)
  More information about the INF 1102 form

• Commercial Employer Pull Notice Requester Account Notice of Change (PDF) (INF 4)
  More information about the INF 4 form

• Employer's Report of Medical Exam Failure/Request for Reexamination of Driver (PDF) DS524
  More information about the DS524 form

• Employer Pull Notice Program Enrollment Packet (PDF) (INF 1250A)
  More information about the INF 1250A form

• Government Employer Pull Notice (PDF) (INF 1103)
  More information about the INF 1103 form

• Government Employer Pull Notice Driver Licensed Out-of-State (PDF) (INF 1103A)
  More information about the INF 1103A form

• Information Security Statement (PDF) (INF 1128)
  More information about the INF 1128 form

• Request for Driver License/Identification Card Status and Record Information (PDF) (INF 1119)
  More information about the INF 1119 form

• Employer Pull Notice Agent Authorization form (PDF) (INF 2110)
  More information about the INF 2110 form

You need version 5 of Adobe Acrobat Reader to view, fill out and print this form. If you have problems with Acrobat Reader or our PDF form, click on Troubleshooting. To obtain a form by mail, contact your local DMV office or call (800) 777-0133 between the hours of 8 a.m. and 5 p.m. PST. For large quantities, read "Ordering DMV Forms in Large Quantities".

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