License Status Report

License Status Change

All university certified drivers are required to report any license status change to the Department of Public Safety, in accordance to Oregon Administrative Rule 571-010-0110.

Prior to certification, all drivers must pass a qualification criterion.  The criterion includes reviewing the driving record of the potential driver.  A license status change is any change occurring to a driving record once a driver is university certified.  Receiving a new citation, having your license suspended or revoked, getting a new license, are examples of license status changes.

 
Last Name:
First Name:
License #:
State:
Department:
Van Training:
Certification Evaluation Date:
Certification Expiration Date:
Type of License Status Change: New Citation  New Revocation/Suspension  New License
Type of Citation:
Date of Citation:
Scheduled Court Date:
State:
New License Number:
State:
Date of Revocation/ Suspension:
Comments:

 

 

   
License Status Change


Department of Public Safety

1319 East 15th Avenue
Eugene, OR  97403
Ph: 541.346.5444  Fax: 541.346.0947

University of Oregon

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