Form 5862 Missouri

Certification of Homeless Status and Residency

The document outlines the requirements for obtaining a Missouri nondriver ID for homeless individuals and unaccompanied youths. Applicants must provide proof of their homeless status and Missouri residency through a certification form completed by an eligible agency. The form requires the applicant's first name, middle initial, date of birth, signature, and Missouri residence address. Additionally, applicants must submit documents to verify their identity, lawful status, Social Security number, and name change if applicable. Eligible agencies include governmental or nonprofit providers serving homeless individuals, licensed attorneys representing homeless individuals, local education agencies for homeless children and youths, and human services or public social services providers. Agencies will retain the certification form and submitted documents as part of the applicant's Homeless Status & Residency application. This certification does not establish proof of the applicant's name, date of birth, or Social Security number. Applicable fees for the nondriver ID apply.