APPLICATION FOR REFUND

INSTRUCTIONS:
This application form (ADM 399) can be used to request refunds for vehicle/vessel registration, driver license, identification
card, special certificate, financial responsibility, and other fees and/or penalties collected by the Department of Motor
Vehicles (DMV). Refund is due when fees were paid in error or were not required to be paid to DMV as stated in California
Vehicle Code §42231 and/or Revenue and Taxation Code §10901.

To apply for a refund of fees and/or penalties collected by DMV that were erroneous, excessive, or not due:
• Read the instructions thoroughly to determine if a refund of fees is due.
• Complete Application for Refund. See the instructions.

Submit the Application for Refund to the nearest DMV office or mail to:
Registration Driver License/Identification Card Occupational Licensing
Department of Motor Vehicles Department of Motor Vehicles Department of Motor Vehicles
PO Box 942869, MS A235 PO Box 942890 Occupational Licensing Section
Sacramento, CA 94269-0001 Sacramento, CA 94290-0001 PO Box 932342, MS L224
Sacramento, CA 94232-3420
DMV will not honor refund requests that are:
• for registration fees:
– when they were paid prior to the sale of the vehicle.
– when the vehicle was operated after the new registration year.
– covering a portion of the year.
– wrecked after fees became due.
• for duplicate certificates and/or stickers when they were applied for voluntarily.
• for parking fees. Please contact the issuing agency or the court for the parking fee refund.
• for use tax. Please contact the California Department of Tax and Fee Administration for the use tax refund.
• received more than three years after the payment was made. This is due to the statute of limitations and the fact that
DMV’s records are no longer available for verification.
• for all types of driver license and/or identification card applications unless the fee was collected in error.

Attach all applicable substantiation for your requested refund:

• Photocopy of the cancelled check (front and back) or credit card receipt showing proof of payment. If payment was
made twice to DMV, please submit photocopies of both cancelled checks or credit card receipts.
• Photocopy of receipts issued by DMV.
• Vehicle registration card/stickers for the year fees are requested to be refunded.
• Photocopy of insurance Statement of Facts showing date of loss.
• Completed Certificate of Non-Operation/Planned Non-Operation Certification (REG 102) form.
• Completed Notice of Transfer and Release of Liability (REG 138) providing the name and address of the purchaser
and the date of sale.
• Completed Nonresident Military (NRM) Vehicle License Fee and Transportation Improvement Fee Exemption
(REG 5045) form.
• Certificate of Title issued for the vehicle or vessel for which the fees are requested to be refunded (if a change or
correction of vehicle or vessel description is also involved).
• Statement of Facts (REG 256) completed and signed authorizing DMV to issue the refund in your name (if you are
other than the registered owner or selling dealer).
• Proof of medical condition which prevented issuance of a driver license.

NOTE: You will be notified of the disposition of your refund within 30 days from the date of receipt of the
Application for Refund in Sacramento. You will be contacted by phone, email or surface mail if additional
items or clarification is required. Please visit DMV’s Refund FAQs Webpage at https://www.dmv.ca.gov/
portal/dmv/detail/online/refund/refundfaqs for more details.

ADM 399 (REV. 6/2020) WWW Print Clear Form

 APPLICATION FOR REFUND

INSTRUCTIONS (continued)
How to complete Application for Refund:
• “Item” corresponds to the numbers shown on the Application for Refund.
• “Item Description” is the same as indicated on the application form.
• “What to Enter” clarifies the information required to be completed by the applicant.

ITEM ITEM DESCRIPTION WHAT TO ENTER

1 Name or Company Name Name (last, first, and middle initial) of the individual(s) and/or company that is
entitled to the refund. Refund is issued back to the original form of payment.
For credit card refunds, the refund is issued back to the credit card holder. If the
refund needs to be issued to a different person, a completed Statement of Facts
(REG 256) is needed.
2 Mailing Address Show complete mailing address. (For an “in care of” (C/O) address, enter the
C/O name first on the mailing address line, followed by the mailing address.)
3 City, State, and Zip Code Show complete city name, state, and zip code.
4 VIN/HIN (Last 3 Characters) Refund of registration fees only: show the last three characters of the vehicle
identification number or vessel hull identification number.
5 Registered Owner or License Registered owner’s name or licensed person’s name if different from the
Name Applicant. Include the registered owner’s or the licensed person’s address in the
blank space under #11 “Other”.

6 License or License Plate Refund of driver license fees: show the license number (Including identification
Number card, driver license, motorcycle license, commercial driver license, special
certificate, occupational license, or financial responsibility, etc.)
Refund of registration fees: show the vehicle license plate number, vessel
registration number, one trip permit number, commercial requester account
number, or IRP fleet number, etc.

6a Registration Mark an “X” in the “Registration” box if refund is for vehicle/vessel related fees.
Driver/ID Mark an “X” in the “Driver/ID” box if refund is for driver license or identification
Occupational card related fees.
Misc. Mark an “X” in the “Occupational” box if refund is for occupational license fees.
For all others, mark an “X” in the “Misc.” box.

7 Date Fees Were Paid Enter the date the fees to be refunded were originally paid.
8 Office Where Enter the name of the DMV office, business partner, or location of the Auto Club
Fees Were Paid where the fees to be refunded were originally paid.
9 Payment Method Mark an “X” in the box of your original payment method.
10 Refund Amount Requested Enter the amount of refund that you are requesting, including dollars and cents.
11 Reason for Refund Mark an “X” in the appropriate box. Mark an “X” in the “Other” box if the reason
for refund is not listed. Write a brief statement justifying the refund request.
If applicant is not the registered owner’s or the licensed person’s include the
registered owner’s or licensed person’s address under “Other”.
12 Signature of Applicant Your signature.
13 Date Enter the date the Application for Refund is signed.
14 Daytime Telephone Number Your daytime area code and telephone number.
15 Email Address Your email address.

Print Clear Form ADM 399 (REV. 6/2020) WWW

 DMV USE ONLY
RECEIVED AND DESTROYED STICKER NO. HERE

YEAR ______
WARRANT NO. (ACCOUNTING USE ONLY)

APPLICATION FOR REFUND

DATE DMV RECEIVED REFUND REQUEST

BUSINESS INDICATOR

B I

SECTION 1 — APPLICANT INFORMATION

1. NAME (LAST, FIRST, MI) OR COMPANY NAME

2. MAILING ADDRESS 3. CITY STATE ZIP CODE

4. VIN/HIN (LAST 3 CHARACTERS) 5. REGISTERED OWNER OR LICENSE NAME 6. LICENSE OR LICENSE PLATE NUMBER
6A. REGISTR ATION DRIVER/ID
OCCUPATIONAL MISC.
7. DATE FEES WERE PAID (MM/DD/Y Y Y Y) 8. OFFICE WHERE FEES WERE PAID 9. PAYMENT METHOD 10. REFUND AMOUNT REQUESTED
CREDIT/DEBIT CASH/CHECK
11. A REFUND OF FEES IS BEING REQUESTED BECAUSE:

Vehicle/vessel left California last operated in California on .

DATE
Vehicle/vessel was sold wrecked stolen on .
DATE
DL/ID/OL Refund Reason
Other (please explain briefly).

I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
12. SIGNATURE OF APPLICANT 13. DATE 14. DAYTIME TELEPHONE NUMBER 15. EMAIL ADDRESS

( )
FOR DMV USE ONLY
SUB M FEE CLEAR ANCE INFO REPORTING UNIT NUMBER TYPE LICENSE TOTAL REFUND

FEE CODES + REFUND FEE CODES + REFUND FEE CODES + REFUND FEE CODES + REFUND
Waiver/County AMOUNT Waiver/County AMOUNT Waiver/County AMOUNT Waiver/County AMOUNT
(008) (088)
AA - AQ63 - 060 VL2 -
(031) (089)
AO - AQ64 - 154 VPC
(069) (093)
AZ - AN - 316
(074) (094)
AD - AU - 501
(075) (095)
AL - AI - 502
(076)
AJ - 001 503
(083)
AT - 002 50L
(084)
AB - 003 AQ1
(085)
AQ - 00L - AR1
(086)
AS - 014 AR0
(087)
AV - 039 EF0
DMV APPROVALS (LEGIBLE SIGNATURE REQUIRED)
TECHNICIAN NAME TECHNICIAN SIGNATURE TECHNICIAN TELEPHONE NUMBER DATE

X ( )
MANAGER NAME MANAGER SIGNATURE MANAGER TELEPHONE NUMBER DATE

X ( )
CREDIT CARD COMPANY NAME
Z96 # ELAVON FIRST DATA

ADM 399 (REV. 6/2020) WWW

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