Declaration of Gender Designation Change for New Jersey Motor

Declaration of Gender Designation Change

for New Jersey Motor Vehicle Commission

Driver License or Non-Driver Identification Card

Vis

it us at www.NJMVC.gov

New Jersey is an Equal Opportunity Employer

GENDER1 (R3/21)

Last Name

First Name

Middle Name

Date of Birth

Street Address

City/State

Zip Code

Driver License/Identification Number

I, ________________________________________, wish to change the gender designation on my driver license/identification

(Print Full Name)

card to read:

 M (male)  F (female) 

X (unspecified).

I, ____________________________________, hereby attest, under penalty of perjury that the request for change in gender to is

to conf

orm my legal gender to my gender identity and is not for any fraudulent purpose.

I certify the statements made by me on this form are true. I am aware that if any of the statements are willfully false, I

am subject to administrative, civil, and/or criminal penalty.

Sig

nature:

__________________________________________________________ Date: __________________________________

Note: You must surrender your current driver license or identification card and obtain a duplicate for the standard fee of $11.00.

In order to change a name on a driver license or identification card, you will need to follow Motor Vehicle Commission

procedures, available at any motor vehicle agency/regional service center or online at www.njmvc.gov

. In most cases this will

require a court order.