[Iowa DOT] 430152. Residency Statement

By demonstrating proof of residency in a state other than Iowa, you may be excused from the requirement to
maintain proof of financial responsibility following a driver’s license suspension or revocation pursuant to Iowa
Code section 321A.17. However, if at any time in the two-year period from the effective date of your suspension or
revocation you apply for a new Iowa license, you will again be subject to the financial responsibility requirements
under section 321A.17

I certify under penalty of perjury and pursuant to the laws of the state of Iowa that the information
provided is true and correct.

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04/13/2026Click to Sign

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