Employer Pull Notice

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Adobe Acrobat Reader is required to view, fill out and print forms. To incorporate the latest accessibility features download of the latest version of Acrobat Reader may be required. If you have problems with Acrobat Reader or our PDF form, select PDF Troubleshooting.

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 (INF 1128 Rev. 3/2004) (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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