Transcription of CERTIFICATION OF PHYSICAL EXEMPTION 49 CFR PART …
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CERTIFICATION OF PHYSICAL EXEMPTION 49 CFR PART …
CDL-10 (Rev. 11/14) CERTIFICATION OF PHYSICAL EXEMPTION 49 CFR PART 391/390 notice :All information on this application must be in INFORMATIONLAST NAME FIRST NAME DATE OF BIRTH (mm/dd/yyyy) DRIVER LICENSE NUMBER SOCIAL SECURITY NUMBER INSTRUCTIONSIf you operate a commercial motor vehicle only in one of the capacities listed below, your commercial driver license will be restricted tothe category(s) you select. Please review and select the applicable category(s) below. CERTIFICATIONI certify that I: a. Am at least 18 years of age, andb. Am not disqualified to drive a motor vehicle in any state, andc. Am exempt from the PHYSICAL provisions of 49 CFR, Part 391/390 as I will operate a commercial motor vehicle only in thecapacities I have checked further certify that I am exempt from the PHYSICAL provisions of 49 CFR, part 391/390, and will operate a commercial motor vehicle onlyin the following capacity.
CDL-10 (Rev. 11/14) CERTIFICATION OF PHYSICAL EXEMPTION 49 CFR PART 391/390 NOTICE:All information on this application must be in INK. APPLICANT INFORMATION LAST NAME FIRST NAME DATE OF BIRTH (mm/dd/yyyy) DRIVER LICENSE NUMBER
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