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SmartMobile™ Removal Authorization

The following client is authorized to have their SmartMobile™ Alcohol Monitoring Device removed as of the date noted below.

This form is intended for state authorities to approve the discontinuation of someone’s SmartMobile™ device/program.

If you are attempting to have an Ignition Interlock removed from your vehicle, please refer to the Device Removal page instead.

"* (required)" indicates required fields

Date of Birth* (required)
Removal authorized on or after* (required)

Please upload any official documentation that may be required to authorize the removal.

Drop files here or
Accepted file types: jpeg, jpg, png, pdf, doc, docx, xls, xlsx, Max. file size: 63 MB, Max. files: 5.
Authorization Approval* (required)
This field is for validation purposes and should be left unchanged.