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DMV-CDL-3 REV 1/13 West Virginia Department of ...

DMV-CDL-3 REV 1/13 West Virginia Department of transportation Division of Motor VehiclesWV Commercial Driver licensee medical self -Certification AffidavitName of DriverLicense NumberEXACTLY AS IT APPEARS ON THE COMMERCIAL DRIVER S LICENSE1.) As a CDL Holder, you must FIRST chose the status that BEST describes you as a commercial driver, Excepted or ONE - Commercial Driver s Name and License NumberPART TWO - Commercial Driver Status SelectionPART THREE - Commercial Driver Certification and Return InformationTHIS FORM MUST BE COMPLETED BY THE COMMERCIAL DRIVER AND RETURNED TO DMVIf you transport school children or you are a Federal, State, or local government employee, and you are exempt from the Federal Motor Carrier Safety Administration (FMCSA)

DMV-CDL-3 REV 1/13 West Virginia Department of Transportation Division of Motor Vehicles WV Commercial Driver Licensee Medical Self-Certification Affidavit

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  Virginia, Department, Medical, Affidavits, Self, Certifications, Transportation, Licensee, Virginia department of transportation, Virginia department, Licensee medical self certification affidavit

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