Chapter 8-4 Melanie’s Law and Ignition Interlock If the applicant answers “no” to either question the clerk must then complete the “Interlock Road Test Form (T21821-0708) and collect the following information from the consumer: • Name • License Number • Address • Phone Number • Whether the customer has a permit (if not, they need to obtain one) • Registration Number • Make of Vehicle • Year of Vehicle • Emergency Brake location • Is there a back seat • Does the vehicle have two separate seats or a bench seat • Closest RMV location Once the form is complete, the clerk will write their name and ALARS ID at the bottom of the form and fax the form to the Road Test Manager. They will then coordinate with the Road Test Supervisors to help the applicant book an exam. 8/00 8:61