Legal ID Changes Financial Assistance Form
This form is to be used to request financial assistance for legal ID changes, including fees to change your birth certificate, driver's license or DMV identification card (Real ID available), passport, and court order affidavit. It is for trans and gender diverse Oregon residents with financial need.

Please fill this out to the best of your ability and a team member will follow up with you as soon as they are able, in order to gather more information and schedule a meeting with you. If you are issued financial assistance and do not use it within 30 days, you must wait six months to reapply to the program.

If you have any questions, please email wellness@transponder.community.

If you haven't seen our documentation change guide yet, please see that here: https://docs.google.com/document/d/1x5kxfYsRnlflUc1tzlChO1QdJ3Rj3burluetqQMnu48/edit?usp=sharing
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First name (Preferred first name, we do not need to know your legal name) *
Last name *
Pronouns
Date of Birth *
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DD
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YYYY
Phone number *
Email address *
Preferred contact method *
May we identify ourselves as 'TransPonder' when we contact you?
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What state do you currently live in? *
What city (or county) do you currently live in? *
What state were you born in?  *
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