Form 427 template
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CERTIFICATION FOR CHANGE OF SEX DESIGNATOR ON DRIVER’S LICENSE OR IDENTIFICATION CARD
This document is a certification form for requesting a change of sex designator on an Alaska driver license or identification card. The applicant must provide one of several qualifying documents, such as Form 478, amended birth certificate, valid US passport, or court order. Section A requires the applicant to fill in their legal name, Alaska DL or ID number, date of birth, and desired sex designation. In section B, the patient authorizes a licensed provider to release related information. Section C is for the licensed provider's certification, which includes the provider's name, address, telephone number, professional license number, and jurisdiction. The provider must certify that they have treated or reviewed the applicant's medical history regarding the condition necessitating the change and expect it to be permanent.
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