Applicant Personal Information
Driver License Expiration Date*
Year*
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
2046
2047
2048
2049
2050
2051
2052
2053
2054
2055
2056
2057
2058
2059
2060
Month*
1
2
3
4
5
6
7
8
9
10
11
12
State*
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NS
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Time at Current Residence*
Years*
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Months*
0
1
2
3
4
5
6
7
8
9
10
11
Marital Status
Married
Unmarried
Separated
Applicant Employment Information
Income Interval*
Weekly
Bi-Weekly
Monthly
Employment Status*
Contract
Full Time
N/A
Part Time
Retired
Seasonal
Self-Employed
Temporary
Employment Type*
Auto Worker
Clerical
Craftman
Executive / Municipal
Farmer
Fisherman
Government
Homemaker
Other
Professional
Sales/Advertisement
Semi-Skilled Labor
Skilled Labor
State*
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NS
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Years*
0
1
2
3
4
5
6
7
8
9
10+
Months*
0
1
2
3
4
5
6
7
8
9
10
11
Applicant Personal Information
Driver License Expiration Date*
Year*
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
2046
2047
2048
2049
2050
2051
2052
2053
2054
2055
2056
2057
2058
2059
2060
Month*
1
2
3
4
5
6
7
8
9
10
11
12
State*
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NS
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Time at Current Residence*
Years*
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Months*
0
1
2
3
4
5
6
7
8
9
10
11
Marital Status
Married
Unmarried
Separated
Applicant Employment Information
Income Interval*
Weekly
Bi-Weekly
Monthly
Employment Status*
Contract
Full Time
N/A
Part Time
Retired
Seasonal
Self-Employed
Temporary
Employment Type*
Auto Worker
Clerical
Craftman
Executive / Municipal
Farmer
Fisherman
Government
Homemaker
Other
Professional
Sales/Advertisement
Semi-Skilled Labor
Skilled Labor
State*
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NS
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Years*
0
1
2
3
4
5
6
7
8
9
10+
Months*
0
1
2
3
4
5
6
7
8
9
10
11