Transcription of APPLICATION FOR TEXAS DRIVER LICENSE OR …
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APPLICATION FOR TEXAS DRIVER LICENSE OR …
APPLICATION FOR TEXAS DRIVER LICENSE . OR IDENTIFICATION CARD FOR DEPARTMENT USE ONLY. RESTRICTIONS/ENDORSEMENTS. NOTICE: All information on this APPLICATION must be in INK. DPS CANNOT REFUND PAYMENT ONCE APPLICATION IS SUBMITTED. ASSIGNED #. applications held only 90 days. APPLICATION for: DRIVER LICENSE COMMERCIAL DRIVER LICENSE (CDL). LEARNER LICENSE IDENTIFICATION CARD. NON-RESIDENT COMMERCIAL DRIVER LICENSE Class (Circle) A B C M. APPLICANT INFORMATION CONTACT INFORMATION. LAST NAME: HOME PHONE: FIRST NAME: OTHER PHONE: MIDDLE NAME: EMAIL: SUFFIX: ADDRESS INFORMATION. RESIDENCE ADDRESS: MAIDEN NAME: DATE OF BIRTH (mm/dd/yyyy): . CITY: STATE: SSN: . ZIP CODE: COUNTY: SEX: (Circle One) MALE FEMALE. MAILING ADDRESS: EYE COLOR: HAIR COLOR: RACE / ETHNICITY: (I) American Indian /Alaska Native CITY: STATE: (A) Asian / Pacific Islander (B) Black (H) Hispanic (O) Other (W) White ZIP CODE: COUNTY: HEIGHT: ft. in. WEIGHT: lbs.
DRIVER LICENSE APPLICANTS Answers to 1 through 7 below are for the confidential use of the Department. YES NO MEDICAL HISTORY QUESTIONS 1. Do you currently have or have you ever been diagnosed with or treated for any medical condition that may affect your ability to safely
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