Form DMS 004. License, ID Card, and Records Payment Authorization - Virginia

Form DMS 004. License, ID Card, and Records Payment Authorization is used by customers to fax payment authorization to the Virginia Department of Motor Vehicles (DMV). The purpose of this form is to authorize payment for specific DMV services or records requested by the customer.

The parties involved in this form are the customers making the payment authorization and the Virginia DMV, which processes the payment and provides the requested services or records. The form sections consist of the customer's identification information and the details of the payment authorization.

Important fields in this form include the customer's name, identification card or driver's license number, the type of service or records requested, and the payment details. Accurate completion of this form is crucial to ensure that the customer's payment is correctly processed by the DMV.

For example, a customer who needs to request specific records from the DMV, such as driving history or vehicle information, can use Form DMS 004 to authorize the payment for these services. By completing this form and providing the necessary payment details, the customer authorizes the DMV to charge the specified amount for the requested records.

No additional documents need to be filled out or completed for this form. As a payment authorization form for specific DMV services or records, there are no related alternative forms for this specific purpose.