DL 142, Request for Cancellation or Surrender of a Driver License or Identification Card (State of California Department of Motor Vehicles) Completed Form Examples and Samples

View a clear, filled-out example of the California DMV Form DL 142, the Request for Cancellation or Surrender of a Driver License or Identification Card. Our sample helps you understand how to correctly complete the form for submission.
DL 142, Request for Cancellation or Surrender of a Driver License or Identification Card (State of California Department of Motor Vehicles) has a moderate Form Complexity Index of 49/100 — Instafill’s AI completes it in under a minute.
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Completed California DMV Form DL 142 sample for surrendering a driver license after moving to a new state.

DL 142 Example – Surrendering a Driver License After Moving Out of State

How this form was filled:

This is a sample of a completed DL 142, Request for Cancellation or Surrender of a Driver License or Identification Card. This specific example demonstrates the common scenario of an individual voluntarily surrendering their California driver license because they have moved to another state and will be issued a new license there. All personal information sections are filled, a clear reason is provided, and the form is signed and dated for 2026.

Information used to fill out the document:

  • Full Name: Jane Emily Doe
  • Driver License Number: D1234567
  • Date of Birth: 05/20/1985
  • Reason for Cancellation: I am moving to another state and obtaining a driver license there.
  • Signature: Jane E. Doe
  • Date of Signature: 01/15/2026

What this filled form sample shows:

  • Correctly filled Section A (Driver License/ID Card Holder) with personal details.
  • A clear and common reason provided for the license surrender.
  • Properly formatted signature and a current date (2026).
  • Demonstrates the required information for a straightforward cancellation request.

Form specifications and details:

Form Name: DL 142, Request for Cancellation or Surrender of a Driver License or Identification Card
Issuing Agency: State of California Department of Motor Vehicles (DMV)
Use Case: Voluntary surrender of a driver license due to moving out of state.
Filing Year: 2026
Categories: CAR forms, California state forms, driver license forms, identification card forms, identification forms, motor vehicle forms, NJ state forms, PA state forms, state ID forms, Department of State forms, state identification forms
Created: February 10, 2026 08:10 PM
Completed California DMV Form DL 142 sample for surrendering a driver license after moving to a new state.