DL 804 Form – The DL 804 form is the official California DMV Participant’s Certification of DUI Program Enrollment or Completion. It serves as a critical legal document for individuals participating in state-licensed Driving Under the Influence (DUI) programs.
This form captures the participant’s signature under penalty of perjury, certifying that they have either enrolled in or completed the required DUI program. It is most commonly used when the participant cannot immediately sign the primary certificates (DL 101 for completion or DL 107 for enrollment), especially during electronic submissions to the DMV.
The form is revised as DL 804 (REV. 1/2003) and remains the current official version from the California Department of Motor Vehicles (DMV).
Why Is the DL 804 Form Required for DUI Programs in California?
California law requires drivers convicted of DUI (under Vehicle Code sections like 23152 or 23140 CVC) to complete a licensed DUI program to reinstate their driving privileges. The DL 804 acts as a backup certification when standard certificates cannot be signed in person.
Key scenarios where the DL 804 is used:
- The participant finishes all program requirements but is absent when the paper DL 101 (Notice of Completion) is issued.
- The DUI program submits the DL 101 or DL 107 electronically via the DMV’s authorized internet link.
- Proof of enrollment (DL 107) or completion (DL 101) needs the participant’s verified signature on file.
DUI program providers must retain the signed DL 804 in their records (searchable by certificate number) and note “Signed DL 804 in file” on any paper DL 101. Providers do not submit the DL 804 to the DMV unless specifically requested.
Official DL 804 PDF Download Link
Download the official blank DL 804 form directly from the California DMV here:
https://www.dmv.ca.gov/portal/uploads/2025/05/DL-804-R1-2003-ASB-WWW.pdf
This is the most current and trusted source. Avoid third-party sites to ensure you get the exact DMV-approved version.
Who Needs to Use the DL 804 Form?
- DUI program participants — Anyone required to attend a First Offender, Multiple Offender, or Education-Only DUI program.
- Licensed DUI program providers — They issue and retain the form as part of compliance with Title 9 California Code of Regulations and DMV rules.
- Drivers seeking license reinstatement — The form helps prove program compliance to the DMV when electronic or delayed processing occurs.
Step-by-Step: How to Fill Out the DL 804 Form?
The form is simple and completed at the DUI program office. Here’s exactly what’s required:
- Program Provider Name and Provider’s ADP License Number — Entered by the program.
- Participant Name (Last, First, Middle).
- Driver License Number or “X” Number.
- Program Type — Check the appropriate box:
- Education Only (23140 CVC Conviction)
- First Offender Program (__ months)
- Multiple Offender Program (18, 30, or 18 of 30 months – IID Restriction only)
- Enrollment Date and DL 107 Certificate Number (for enrollment).
- Completion Date and DL 101 Certificate Number (for completion).
- Participant’s Signature and Date — Signed under penalty of perjury.
- Telephone Number.
All information must match the corresponding DL 101 or DL 107 certificate exactly.
DL 804 vs. DL 101 vs. DL 107: What’s the Difference?
| Form | Purpose | When Used | Signature Required? |
|---|---|---|---|
| DL 804 | Participant’s certification (backup) | When participant cannot sign DL 101 or DL 107 in person | Yes (on DL 804) |
| DL 107 | Proof of Enrollment | At start of DUI program | Normally yes; DL 804 used if electronic |
| DL 101 | Notice of Completion | Upon successful program finish | Normally yes; DL 804 used if electronic or absent |
The DL 804 ensures the DMV receives verified proof even when the primary certificate lacks an on-site signature.
How the DL 804 Fits Into the California DUI License Reinstatement Process?
- DUI conviction → Court orders program.
- Enroll in licensed DUI program → Receive DL 107.
- Complete all required hours, fees, and sessions → Receive DL 101 (or use DL 804).
- DMV receives electronic/paper proof → Driving privileges may be reinstated (after any suspension period, SR-22 filing, etc.).
Completing the program and submitting proper certification is mandatory for full license restoration.
Frequently Asked Questions About the DL 804 Form
Can I download and fill out the DL 804 myself?
No. It must be completed and retained by a licensed DUI program provider. Participants only sign it at the program office.
Is the DL 804 the same as a completion certificate?
No. It is supporting documentation. The actual completion proof sent to the DMV is the DL 101.
How long must providers keep the DL 804 on file?
For the period required by Title 9 regulations (typically several years for audit purposes).
Where can I find a list of licensed DUI programs?
Visit the California DMV website or contact your county’s alcohol and drug program administrator.
Official DMV Resources for DUI Programs
- Official DL 804 form page: DMV DL 804 Form
- California DUI Program information: dmv.ca.gov (search “DUI programs”)
- Always use the direct PDF link provided above for the most current version.
Important Note: Laws and forms can be updated. Verify all details directly on the official California DMV website and consult your DUI program provider or a legal professional for personalized advice regarding your driving privileges.
This guide is based exclusively on current official California DMV sources and regulations as of 2026. Download your DL 804 PDF today and ensure your DUI program compliance is properly documented.