Form HSMV 96020, Request to Withhold Personal Information, is the sworn request that eligible public officials, law enforcement personnel, servicemembers and others use to ask the Florida Department of Highway Safety and Motor Vehicles (FLHSMV) to withhold their residential address from driver license and vehicle records, under Section 119.071, Florida Statutes. Spouses, children and dependents of eligible people can be included. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the PDF is posted on the Alachua County Tax Collector's website, and the request itself goes to FLHSMV.
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What is HSMV 96020?
Form HSMV 96020, Request to Withhold Personal Information, is the form on which a person eligible under Section 119.071, Florida Statutes, asks the Florida Department of Highway Safety and Motor Vehicles (FLHSMV) to withhold personal information held in their driver/identification and vehicle/vessel records. Its printed title is "Public Official, Law Enforcement Agency Personnel and Others Request to Withhold Personal Information Pursuant to Section 119.071, Florida Statutes."
The privacy protection covers current and former sworn or civilian law enforcement personnel, active or former public officials, servicemembers (active, or former after 09/11/2001) and other identified individuals, plus their spouses, children or dependents who are eligible under the statute.
The form states an important limit. FLHSMV keeps a residential address and a mailing address for each person, and the protection applies only to the residential address, not the mailing address. If you give no separate mailing address, your residential address is listed as your mailing address. The form notes that mailing addresses are routinely released for official business about motor vehicle or driver license information.
The request has four parts: the statutory basis for the exemption, the requester's personal information and up to three family members, a statement made under penalty of perjury, and a notary's jurat. The last page lists the categories of people covered and refers you to Section 119.071 for the details of each exemption.
Who needs to file HSMV 96020?
Eligible people who want FLHSMV to withhold personal information in their driver/identification and vehicle/vessel records use this form. The form names these groups, subject to the conditions in Section 119.071, Florida Statutes:
- current and former sworn or civilian law enforcement personnel, including correctional and correctional probation officers;
- current and former public officials, such as justices, judges, state attorneys, public defenders, magistrates, code enforcement officers and county tax collectors;
- current and former certified firefighters and emergency medical technicians or paramedics certified under chapter 401, F.S.;
- current and former servicemembers who served after September 11, 2001;
- current and former U.S. attorneys and federal judges listed on the form, and other categories printed on the last page.
Spouses, children and dependents of eligible people can be included. The form has space for three family members; for more, complete additional forms or attach an additional sheet.
Eligibility must be shown: the form requires a statement of eligibility and documentation that indicates it. Check Section 119.071 for the specifics of each exemption. The request does not block your mailing address, so it will not stop FLHSMV from releasing that address for official business.
When to file HSMV 96020
The form prints no deadline. You submit it when you are eligible under Section 119.071, Florida Statutes, and want FLHSMV to withhold your personal information from your driver/identification and vehicle/vessel records.
If you also want your residential address blocked and not displayed on your driver license or identification card, the form says to make an appointment with your local driver license issuance office to provide a separate mailing address and get a replacement card. Without a separate mailing address, FLHSMV lists your residential address as your mailing address.
Documents you need
- Documentation indicating your eligibility under Section 119.071, Florida Statutes: the form requires it with every request.
- A statement of eligibility, together with the documentation: the form says FLHSMV must have both.
- An additional sheet or additional copies of the form for eligible family members, only if you are including more than the three spouse/child spaces provided.
How to fill out HSMV 96020
Gather your license and eligibility proof
Have your Florida driver license or identification card in hand, since the form says the required information is located on it. Also collect the statement of eligibility and documentation that shows you qualify.
Indicate the statutory basis
On the line "Please indicate statutory basis for exemption. See Page 3," enter the exemption from the list on the last page of the form that applies to you.
Enter your personal information
Enter your first, middle and last name, street address, city, state and ZIP code. Add your Florida Driver License/Identification Card Number and your Date of Birth, which must match your license record.
List family members, if included
For each eligible spouse or child, use lines 1 to 3 to enter the Florida Driver License/Identification Card Number and Date of Birth. For more than three, complete additional forms or attach an additional sheet.
Print your name and sign
Under the penalty-of-perjury statement, enter the Print/Type/Stamp Requestor's Name and sign as requestor. By signing you affirm that you qualify for the exemption claimed.
Have the notary complete the jurat
Sign before a commissioned notary, by physical presence or online notarization. The jurat takes the day, month and year, your name, whether you are personally known or produced ID, and the type of ID produced. The notary prints their name and signs.
Attach your eligibility documentation
Add the documentation indicating your eligibility and the statement of eligibility, plus any additional sheet for family members.
Review and download the completed PDF
Check that names, license numbers and dates of birth match your license records and that the signature and notary sections are complete. Download or print the completed PDF from FillingPDF and send it as described under How to submit.
How to submit HSMV 96020
You can return Form HSMV 96020 to FLHSMV by mail or by email, together with documentation of your eligibility.
- By mail: Florida Department of Highway Safety and Motor Vehicles (FLHSMV), 2900 Apalachee Parkway, MS 28, Tallahassee, Florida 32399.
- By email: [email protected].
Complete the signature and notary sections before sending, and include the statement of eligibility and the documentation that indicates it. If you are listing family members, make sure each has their own license or ID number and date of birth on the form, or add forms or sheets for them. To have a separate mailing address recorded and a replacement license or ID card issued, make an appointment with your local driver license issuance office. FillingPDF lets you fill out and download the PDF; submission follows the channels above.
Common mistakes to avoid
- Assuming the request blocks your mailing address; the protection applies only to the residential address, and mailing addresses are routinely released for official business.
- Entering a date of birth that differs from the one on the Florida driver license or identification card record; the form says it must match.
- Sending the request without documentation indicating eligibility or without a statement of eligibility.
- Leaving the statutory basis for exemption blank; the form asks you to indicate it, referring to the list on page 3.
- Not providing a separate mailing address when you want your residential address kept off your license; FLHSMV then lists the residential address as your mailing address.
- Signing the requestor's affirmation but leaving the notary's jurat incomplete, or signing outside the notary's presence.
- Cramming more than three family members onto the form instead of completing additional forms or attaching an additional sheet.
- Copying license numbers from memory instead of from the Florida driver license or identification card, where the form says the information is located.
Frequently asked questions
What is Form HSMV 96020 used for?
Form HSMV 96020 is a request that FLHSMV withhold personal information in your driver/identification and vehicle/vessel records. Eligible people use it under Section 119.071, Florida Statutes, and it protects the residential address only, not the mailing address.
Is this an Alachua County property tax form?
No. It is not a property tax document. The form is addressed to the Florida Department of Highway Safety and Motor Vehicles (FLHSMV) and concerns driver license and vehicle records. The PDF happens to be posted on the Alachua County Tax Collector's website.
Who is eligible to use the public official block form?
Current and former law enforcement personnel, public officials, certified firefighters, servicemembers who served after September 11, 2001, and other groups listed on the form, plus eligible spouses, children and dependents. Section 119.071, Florida Statutes, sets the specifics of each exemption.
Does the form need to be notarized?
The form includes a notary section: it is sworn or affirmed and subscribed before a commissioned notary by physical presence or online notarization. The notary enters the date, your name, how you were identified and signs.
Where do I send Form HSMV 96020?
Mail it with your eligibility documentation to FLHSMV, 2900 Apalachee Parkway, MS 28, Tallahassee, Florida 32399, or email it to [email protected]. The form lists no other channel.
Will my address be hidden on my driver license?
Only if you provide a separate mailing address. FLHSMV lists your residential address as your mailing address otherwise. To block it on the card, make an appointment at your local driver license issuance office to give a mailing address and get a replacement license.
Can I include my spouse and children on one form?
Yes, up to three. The form has spaces for each family member's Florida driver license or ID number and date of birth. For more, complete additional forms or attach an additional sheet, and include documentation showing their eligibility.
Can I fill out Form HSMV 96020 online?
You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service and does not file or send the request; you sign it before a notary and deliver it to FLHSMV by mail or email.
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