SAVE Rev Verification Request Form

Transcript

1 Kansas Department of Revenue SAVE Verification – Request Form Division of Vehicles Instructions: Submitting or Desired Exam Office: • Requestor must submit legible photocopies of legal documents to be verified in PDF format. • Requestor must complete all information indicated in the Requestor Date Received: Information section of this document. • The Kansas Department of Revenue SAVE Coordinator will contact the Requestor by mail, email or phone to review findings. SAVE Case Verification Number: • Do NOT Open a New Case Number once a Number has been assigned (Performing this action will result in a delay with response time). Please Check Submitted Documents: ☐ I-327 (Reentry Permit) Must include copy of the back side of card I-551 (Permanent Resident Card) – ☐ I-571 (Refugee Travel Document) ☐ ☐ I-766 (Employment Authorization Card) Certificate of Citizenship ☐ Naturalization Certificate ☐ Machine Readable Immigrant Visa (with Temporary I-551 Language) ☐ Temporary I-551 Stamp (on Passport or I-94) ☐ Must include I-20 if student -94 (Arrival/Departure Record) – I ☐ I-94 (Arrival/Departure Record) in Unexpired Foreign Passport – -20 if student I Must include ☐ ☐ Unexpired Foreign Passport ☐ I-20 (Certificate of Eligibility for Nonimmigrant (F-1) Student Status) D S2019 (Certificate of Eligibility for Exchange Visitor (J-1) Status) ☐ O ther (Use Document Description) ☐ Requestor Information (Please Print Legibly): Middle Initial First Name Last Name Date of Birth Address Kansas Driver’s License or Non-Driver ID Number City Zip Code State Fax Number Telephone Number Email Address ) ( ) ( Additional Comments: Mail To: Division of Vehicles SAVE Coordinator PO Box 2188 Topeka, KS 66601-2188 [email protected] Email: Rev 10-17

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