Emergency Contacts - Utah Department of Public Safety

Last Name: Enter your last name. REQUIRED

Driver License Number or ID Number: Enter Driver License Number or ID Number. REQUIRED

Issue Date: Enter the issue date (mm/dd/yyyy). REQUIRED

Last 4 of SSN/ITIN: Enter Last 4 of SSN/ITIN. REQUIRED

I DO NOT have a Social Security Number or ITIN.

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