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 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 |
Created: February 10, 2026 08:10 PM
