Eligibility Requirements – Follow all instructions. Incomplete applications will be returned.
Call before submitting this revocation application to determine if you are eligible for reinstatement:
For assistance, please contact MVD: azdot.gov/contactmvd or Call 602.255.0072 (TDD 602.712.3222).
You must meet all of the following criteria before you may submit this revocation application:
1. Your revocation period has ended. For violations of failure to stop and render aid at the scene of an accident involving death, at least five years of your revocation period has elapsed.
2. If your driving privilege was also suspended, the suspension period must also have ended.
3. If your driving privilege was suspended as a result of a judgment filed against you in court (e.g., for damages arising from a motor vehicle accident), you must provide written consent or the court in which the judgment was filed may provide a document indicating that the judgment was satisfied.
4. Arizona will not grant reinstatement of your Arizona driving privilege if your driving privilege is withdrawn, revoked or suspended in another state.
5. If you have any traffic complaints/violations against you, you must first resolve all court requirements and obtain a written satisfaction from the courts.
6. If you have been convicted of any traffic violations within the preceding 12 months, we are not authorized to accept your application for reinstatement until 12 months have passed since the date of the violations.
Form Instructions – Follow All Instructions
1. Provide complete answers to all questions. Do not leave spaces blank.
2. Read Authorization to Release Information, then sign and date.
3. For revocations not related to alcohol or drugs, mail only the customer portion of the application to Mail Drop 530M, Driver Improvement Unit, Motor Vehicle Division, P O Box 2100, Phoenix, AZ 85001-2100. The substance abuse evaluation portion will not be needed.
Substance Abuse Evaluation portion – alcohol/drug related revocations only
1. Application shall be received within 1 year after the date it was signed by an approved evaluator.
2. During the substance abuse evaluation you must disclose ALL DUI, alcohol and drug related offenses (traffic, criminal and out-of-state).
3. This form must be completed by an approved evaluator.
1 A “mandatory insurance” or “financial responsibility” suspension generally results from the failure to maintain required minimum levels of insurance on a vehicle titled and registered in your name. Whether the suspension is court-ordered or the result of MVD action, a reinstatement fee will be due at the end of the suspension period. If it is a court-ordered suspension, we must receive written consent or a clearance letter from the court before driving privileges can be reinstated. Other actions may also be required, depending on the nature of the suspension.
2 An SR-22 is a form of high-risk insurance, or proof of future financial responsibility, which may be required in some insurance-related actions. SR-22 insurance may be purchased from any insurance company authorized to do business in Arizona.
99-0139 R05/22 azdot.gov
4. The approved evaluator must submit the original application to MVD and a copy of their professional certification/license.
5. You are responsible for any expenses required to complete the substance abuse evaluation.