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Forfeiture of Driver's License

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North Carolina Court Forms

STATE OF NORTH CAROLINA

County

File No.

In The General Court Of Justice

STATE VERSUS

Name Of Defendant

FORFEITURE OF DRIVERS LICENSE
FAILURE TO COMPLETE
COMMUNITY SERVICE

Date Of Birth

G.S. 143B-708

Defendant's Drivers License No.

State

Hours Of Community Service Work Ordered

Community Service Fee Ordered

$

I. FINDINGS AND ORDER REVOKING LICENSE

The defendant was placed on probation pursuant to the Judgment Suspending Sentence or order to defer prosecution previously entered in this case, and was ordered as a condition of probation to perform the number of hours of community service work specified above, as directed by the judicial service coordinator, and to pay any fee listed above. Upon report by the judicial service coordinator of a significant violation of this condition of probation, upon due notice to the defendant of a hearing to determine if there is a willful failure to comply with that condition, and after such hearing, the Court FINDS that the defendant willfully failed to comply with the community service condition of probation. The Court ORDERS that the defendant's drivers license is revoked as of the date of this Order and shall remain revoked until the defendant has complied with the community service condition of the defendant's probation, as reported by the judicial service coordinator directly to the Clerk of Superior Court.

NOTE TO CLERK: Report this Forfeiture to the Division of Motor Vehicles using the appropriate field in ACIS. If this field is unavailable, mail a copy of this side to: Division of Motor Vehicles, Driver License Data Processing Unit, 3120 Mail Service Center, Raleigh, NC 27699-3120.

Date

Name Of Presiding Judge (Type Or Print)

Signature Of Presiding Judge

II. FINDING AND ORDER - POST REVOCATION COMPLETION DISPUTE

NOTE: If the community service staff has filed a Community Service Work Program Form DCC-CSW-2, this Section should not be completed and the Clerk should report the completion of community service work to the Division of Motor Vehicles as explained below.

Pursuant to the above Order, the defendant's drivers license was revoked because the defendant had willfully failed to comply with the community service condition of probation. A dispute has arisen as to whether the defendant has now done so. After due notice and hearing, the Court finds:

Date

Name Of Presiding Judge (Type Or Print)

Signature Of Presiding Judge

NOTE TO CLERK: If option Number 1 or option Number 2 is checked, report compliance with the community service condition to the Division of Motor Vehicles using the appropriate field in ACIS. If this field is unavailable, mail a copy of this side to: Division of Motor Vehicles, Driver License Data Processing Unit, 3120 Mail Service Center, Raleigh, NC 27699-3120.

Material opposite unmarked squares is to be disregarded as surplusage.
(Over)

AOC-CR-317, Rev. 8/12
2012 Administrative Office of the Courts

FORFEITURE OF LICENSING PRIVILEGES
FELONY PROBATION REVOCATION

Date Of Birth

Social Security No.

Date Of Judgment Suspending Sentence

Name Of County & File No. (Co. Of Origin)

Beginning Date Of Forfeiture

Ending Date Of Forfeiture

G.S. 15A-1331.1

On the basis of the record in this case and any evidence presented, the Court, having entered the attached judgment, which is incorporated by reference, makes the following further findings and includes these findings in the judgment. The judgment is modified to the extent necessary to include these findings, but the inclusion of these findings does not otherwise alter, amend, or modify the judgment in any respect.

The Court FINDS that the defendant holds a licensing privilege issued by each of the licensing agencies named below, has been convicted of a felony and is subject to forfeiture of those licensing privileges because the defendant's probation was revoked or suspended and the defendant failed to make reasonable efforts to comply with the conditions of probation. The period of license forfeiture begins on the "Beginning Date Of Forfeiture" shown above and ends on the "Ending Date Of Forfeiture" shown above.

NOTE: The "Beginning Date Of Forfeiture" is the date of the entry of this judgment. The "Ending Date Of Forfeiture" is the end date of the full probationary term as set at the time of conviction. The license forfeiture may not extend beyond the end date of the defendant's probation as set at the time of conviction.

North Carolina Division of Motor Vehicles

Driver License Data Processing Unit

3120 Mail Service Center

Raleigh, NC 27699-3120

Name And Address Of Any Other Licensing Agency (Felony Revocation Only)

Defendant's Drivers License No.

State

License Privilege No.

Name And Address Of Any Other Licensing Agency (Felony Revocation Only)

Name And Address Of Any Other Licensing Agency (Felony Revocation Only)

License Privilege No.

License Privilege No.

Date

Name Of Presiding Judge (Type Or Print)

Signature Of Presiding Judge

NOTE TO CLERK: Report the forfeiture of a drivers license to the Division of Motor Vehicles using the appropriate field in ACIS. If this field is unavailable, mail a copy of this side to: Division of Motor Vehicles, Driver License Data Processing Unit, 3120 Mail Service Center, Raleigh, NC 27699-3120. Report the forfeiture of any other license to the licensing agency by mailing a copy of this side to the agency at the address shown above.

Material opposite unmarked squares is to be disregarded as surplusage.

AOC-CR-317, Side Two, Rev. 8/12
2012 Administrative Office of the Courts

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What the Forfeiture of Driver's License document is

A Forfeiture of Driver's License is a legal form used when an individual relinquishes or surrenders driving privileges or returns a physical license to an authority. It records the signer's identity, license details, factual reason for forfeiture (for example, conviction, administrative order, or voluntary surrender), the effective date, and any reinstatement conditions. Courts, motor vehicle departments, insurers, or employers may require the form as a formal record; the document creates an auditable trail to support administrative or legal processes.

Why documenting forfeiture matters

Used to create a clear, dated record of license relinquishment, the Forfeiture of Driver's License helps document consent, inform agencies, and support administrative processes. It reduces disputes about timing and authority and provides a basis for reinstatement steps or enforcement actions.

Why documenting forfeiture matters

Who completes or accepts this form

Typical users who complete or request this document include agencies, defendants, insurers, and legal representatives.

  • State motor vehicle agencies and DMV clerks processing administrative actions.
  • Courts and prosecutors documenting criminal convictions, plea agreements, or surrender orders.
  • Insurance companies and employers verifying status for coverage or workplace eligibility.

Records are typically retained by the filing party and shared with relevant agencies to support enforcement, licensing, or reinstatement processes.

Who signs and why

Primary Signer

The individual surrendering the license signs to acknowledge forfeiture. Include full legal name, license number, state, and date; signature establishes intent and attribution under ESIGN (15 U.S.C. §7001) and state electronic transaction statutes where applicable.

Agency Official

A DMV or court official may sign to record acceptance or attach a stamped acknowledgment. Their signature or seal documents receipt and recording; some states require notarization or witness attestation to validate the record.

Step-by-step: complete and submit the form

Follow these steps to complete and submit the Forfeiture of Driver's License form correctly and minimize processing delays.

  • 01
    Prepare: Gather ID, license, court order, and supporting documents.
  • 02
    Complete: Fill fields accurately; use MM/DD/YYYY dates.
  • 03
    Authenticate: Sign, and if required, have notarized or witnessed.
  • 04
    Submit: File with DMV, court, or insurer as directed.

Where to send the completed form

After completion, route the form to the appropriate authority; retain copies and confirm receipt to ensure the forfeiture is recorded.

  • To DMV: Submit to local motor vehicle department for record update.
  • To Court: File with court clerk if linked to prosecution or order.
  • To Insurer: Provide copy for claims or policy adjustment.
  • Retain Copy: Keep original and at least one certified copy.

Configuring an online signing workflow

Configure an online workflow to collect e-signatures, optional authentication, and automatic delivery to agencies for efficient processing and audit trails.

Field configuration and platform mapping Action | Platform/Setting
Signer authentication method selection for each signer SMS code, email link, or KBA
Document field mapping and validation rules Required fields, date format MM/DD/YYYY
Delivery and routing rules per signer Automatic copy to DMV and court clerk
Retention and audit trail settings configuration Store signed PDF, audit log, and timestamps

Technical requirements for eSubmission and storage

Ensure file formats, signature methods, and integrations meet agency requirements and accept electronic submissions for reliable processing and auditability.

  • Supported Formats: PDF, DOCX, PDF/A accepted.
  • Authentication Options: Email link, SMS code, or SAML SSO.
  • Integrations: Connect to DMV records, court systems, or case management.

Essential data elements to include

Full Legal Name: Must match government-issued identification exactly.
Driver License Number: Include all letters, numbers, and suffixes.
State of Issue: Use two-letter postal abbreviation
Date of Birth: Enter as MM/DD/YYYY format
Reason for Forfeiture: Concise factual description required
Signature and Date: Signer initials not sufficient; full signature

Consequences of errors or omissions

Processing Delay: Incomplete forms delay recording.
Reinstatement Fees: Fees may be required to restore license.
Legal Penalties: False statements risk perjury charges.
Insurance Impact: Coverage could be denied or increased.
Administrative Hold: License may remain suspended until resolved.
Data Mismatch: Incorrect identifiers can invalidate filing.

Common preparation mistakes to avoid

  • Failing to include the exact license number or state of issue often prevents agencies from matching records, causing processing delays and extra correspondence.
  • Using inconsistent party names, nicknames, or outdated addresses increases the risk that the forfeiture will not be accepted or will need amendment.
  • Skipping notarization or witness steps required by state law leads to rejection; confirm local requirements before relying on an unsigned electronic copy.
  • Submitting different versions to multiple agencies without tracking causes inconsistent records; always retain the executed original and certified copies for all parties.

E-signature provider comparison for submitting legal forms

Overview comparing signNow and common e-signature providers on price, core features, and typical compliance capabilities relevant to filing and notarizing legal forms.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial Varies by plan Varies by plan Free plan available Free plan available
Bulk Send Yes (Business Premium) Yes Yes Yes Yes
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No
Envelope Cap No cap 100 envelopes/user/year Varies by plan Varies by plan Varies by plan

Frequently asked questions about completion and filing

Common questions about completing, signing, and filing a Forfeiture of Driver's License, including electronic signature acceptance, notarization, and where to submit the executed document.


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