Form VSD165.5 "Notice of Address Change" - Illinois

What Is Form VSD165.5?

This is a legal form that was released by the Illinois Secretary of State - a government authority operating within Illinois. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2005;
  • The latest edition provided by the Illinois Secretary of State;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form VSD165.5 by clicking the link below or browse more documents and templates provided by the Illinois Secretary of State.

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Download Form VSD165.5 "Notice of Address Change" - Illinois

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Secretary of State
This space for use by
Notice of Address Change
Secretary of State
Driver Services Department
Secretary of State
Vehicle Services Department
_______________________
501 S. Second St.
Commercial Driver’s License Holders May Not Use
Date
This Form for Driver’s License Changes
Springfield, IL 62756
217-782-6306
www.cyberdriveillinois.com
❒ Yes
❒ No
I am on active duty in the military.
❒ Yes
❒ No
I am a student in good standing at a school in a state other than Illinois.
You are required to notify the Secretary of State in writing of any change of address within 10 days. Complete this form and
return it to any Driver Services facility or mail the completed form to the address above. You will NOT receive a new driver's
license or state ID card when using this form. To obtain a corrected driver’s license or state ID card, please submit the correct
application and fee at any Driver Services facility.
❒ License Plate Registration Address Only
❒ Driver's License/State ID Card
To Change:
❒ Yes
❒ No
Do you require a voter's registration packet?
If yes, a voter registration packet will be mailed to you. When you complete the form, mail it to your local election authority,
which will process your application and mail you a voter's registration card. If you apply to vote within 30 days of an election,
your local election authority will be unable to process your request, and you will not be eligible to vote in that election.
Please Type or Use Ballpoint Pen
Change from: Name(s) — First, Middle, Last
Change to: Name(s) — First, Middle, Last
*Street Address
Street Address
City
State
ZIP
City
State
ZIP
County
Date of Birth
Sex
County
Current Driver’s License or State ID Card Number(s)
*Required by the Driver Services Department if residence is in a city with a population of more than 3,500. Otherwise, a P.O. Box is acceptable.
Vehicle Year & Make
License Plate Number
Expiration Date
Vehicle Identification Number
A change of address on the registration does not require a change of address on the title.
A change of name will require the title to be corrrected. Please indicate the number of corrected title/registration forms
you require:
❒ Corrected Title Applications(s)
❒ Corrected Registration Applications(s)
Printed by authority of the State of Illinois. June 2005 — 75M — VSD 165.5
Secretary of State
This space for use by
Notice of Address Change
Secretary of State
Driver Services Department
Secretary of State
Vehicle Services Department
_______________________
501 S. Second St.
Commercial Driver’s License Holders May Not Use
Date
This Form for Driver’s License Changes
Springfield, IL 62756
217-782-6306
www.cyberdriveillinois.com
❒ Yes
❒ No
I am on active duty in the military.
❒ Yes
❒ No
I am a student in good standing at a school in a state other than Illinois.
You are required to notify the Secretary of State in writing of any change of address within 10 days. Complete this form and
return it to any Driver Services facility or mail the completed form to the address above. You will NOT receive a new driver's
license or state ID card when using this form. To obtain a corrected driver’s license or state ID card, please submit the correct
application and fee at any Driver Services facility.
❒ License Plate Registration Address Only
❒ Driver's License/State ID Card
To Change:
❒ Yes
❒ No
Do you require a voter's registration packet?
If yes, a voter registration packet will be mailed to you. When you complete the form, mail it to your local election authority,
which will process your application and mail you a voter's registration card. If you apply to vote within 30 days of an election,
your local election authority will be unable to process your request, and you will not be eligible to vote in that election.
Please Type or Use Ballpoint Pen
Change from: Name(s) — First, Middle, Last
Change to: Name(s) — First, Middle, Last
*Street Address
Street Address
City
State
ZIP
City
State
ZIP
County
Date of Birth
Sex
County
Current Driver’s License or State ID Card Number(s)
*Required by the Driver Services Department if residence is in a city with a population of more than 3,500. Otherwise, a P.O. Box is acceptable.
Vehicle Year & Make
License Plate Number
Expiration Date
Vehicle Identification Number
A change of address on the registration does not require a change of address on the title.
A change of name will require the title to be corrrected. Please indicate the number of corrected title/registration forms
you require:
❒ Corrected Title Applications(s)
❒ Corrected Registration Applications(s)
Printed by authority of the State of Illinois. June 2005 — 75M — VSD 165.5
Place 1st
Class
Stamp
Here
JESSE WHITE
SECRETARY OF STATE
VSD LICENSE CORRECTION SECTION
501 S. SECOND ST.
SPRINGFIELD, IL 62756-0001
(First Fold)
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