Transcription of CDL Holder Self-Certification - New Jersey
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CDL Holder Self-Certification - New Jersey
CDSC-1 (R12/17) PAGE 1 OF 1 CDL Holder Self-Certification Name of Driver: _____ New Jersey Driver License Number: _____ Are you submitting a copy of your medical certificate? YES NO Note: All CDL holders, Class A, B or C, must submit this Self-Certification ; however only Class A, B or C drivers that check the box for Category 1 or 3 on the Self-Certification categories listed below must submit a copy of their medical certificate. Please check only one of the following Self-Certification categories that apply to you. NOTE: ALL DRIVERS LESS THAN 21 YEARS OF AGE ARE ONLY ALLOWED TO OPERATE IN INTRA-STATE COMMERCE AND MUST CHECK EITHER BOX 3 OR 4.
CDSC-1 (R12/17) PAGE 1 OF 1 CDL Holder Self-Certification Name of Driver: _____ New Jersey Driver License Number: _____ Are …
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