APPLICATION for INTERNATIONAL DRIVING PERMIT or …

1 APPLICATIONforINTERNATIONAL DRIVING PERMITorINTER-AMERICAN DRIVING PERMITI ssuance of PERMIT is restricted to persons EIGHTEEN YEARS or over who hold a valid or Territorial VALID FOR ONE YEAR. Not renewable. MUST BE ISSUED WITHIN 6 MONTHS OF APPLICATION DESIRED PERMIT INTERNATIONAL DRIVING PERMIT Inter-American DRIVING PERMIT **(See reverse side)(Fee $ and 2 Passport Type Photos signed on back)(Fee $ and 2 Passport Type Photos signed on back)MANDATORY REQUIREMENTS(1) Attach 2 recent Passport Type Photos (2" X2")(2) Enclose PERMIT fee of $ (NO CASH)(3) If mailing APPLICATION , a photocopy of BOTH SIDESof Driver s License must accompany completed REQUIREMENTS(1)

2 ADDITIONAL POSTAGE IN FUNDS FOR EXPEDITED RETURN MAIL (SEE FOR RATES)NOTE: IT IS IMPORTANT THAT YOUR OR TERRITORIAL LICENSE BE CARRIED WITH THE PERMIT AT ALLTIMES. The INTERNATIONAL or Inter-American PERMIT is not valid for DRIVING in the United Mrs. Ms. (Circle One)PRINT NAME IN FULL. (MUST MATCH LICENSE EXACTLY)FIRST MIDDLE LASTPHONE HOME STREET ADDRESSCITYSTATEZIP DRIVER S LICENSE NO.

3 STATE OF ISSUEEXPIRATION DATEBIRTHPLACE: CITY STATE OR COUNTRYBIRTH DATE (MO. DAY YEAR)DATE PERMIT TO BE EFFECTIVEDEPARTURE DATE FROM ADDRESS (If known)FOREIGN PHONE (If known)EMAIL ADDRESSPLEASE CHECK THE APPROPRIATE BOX BELOW TO INDICATE THE TYPE OF VEHICLE FOR WHICH YOU NOW HOLD A VALID OR TERRITO-RIAL DRIVER S LICENSE, AND FOR WHICH YOU DESIRE THIS PERMIT . MOTORCYCLE PASSENGER CAR VEHICLE OVER 7,700 LBS.

4 VEHICLE OVER 8 SEATS VEHICLE WITH HEAVY TRAILERI CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND CORRECT, AND THAT THE LICENSE INDICATED HAS NOT BEEN SUSPENDED NOR FURTHER CERTIFY THAT I UNDERSTAND THAT A VALID STATE DRIVER S LICENSE MUST ACCOMPANY THIS PERMIT , AND THAT THIS PERMITIS VALID ONLY AS LONG AS THE STATE LICENSE IS VALID, BUT NOT TO EXCEED ONE YEAR FROM THE DATE THE PERMIT IS (signature mandatory for issuance of PERMIT )DATEIF APPLYING BY MAIL:THIS IS YOUR MAILING LABELP lease print to ensure prompt : FOR LOCAL OFFICE ADDRESS TO SUBMIT APPLICATIONFOR NO.

5 9509 (1/09)STOCK NO. 1252 NAMESTREETCITYSTATEZIP CODECOUNTRYFEE FOREACH PERMIT $ ISSUEDSENT TO:Afghanistan*AlbaniaAlgeriaAndorra*Ang ola*Anguilla*/**Antigua*/**Argentina**Ar menia*ArubaAustraliaAustriaAzerbaijan*Ba hamasBahrain*BangladeshBarbados**Belarus *BelgiumBelizeBeninBhutan*Bolivia*/**Bos nia*BotswanaBrazil (Inter-American DRIVING PERMIT only)Brunei*BulgariaBurkina Faso* (was upper Volta)Cambodia (was Kampuchea)Cameroon*CanadaCape Verde Islands*Cayman Islands*Central African *Chile**Colombia*/**Comoros*Congo, Rep.

6 Of (Brazzaville)Congo, Dem. Rep. of (Kinshasa)Costa Rica*/**Cote d Ivoire (Ivory Coast)Croatia*CubaCuracaoCyprusCzech *Dominica*/**Domincan Rep.**Ecuador**EgyptEl Salvador*/**Equatorial Guinea*Estonia*FijiFinlandFrance (including French overseas territories)French PolynesiaGabon*GambiaGeorgiaGermany*Ghan aGibraltarGreeceGrenada**Guatemala**Guer nseyGuinea*Guinea-Bissau*GuyanaHaiti**He rzegovina*Honduras*/**Hong KongHungaryIcelandIndiaIndonesia*Iran*Ir elandIsraelItalyJamaicaJapanJerseyJordan *Kazakhstan*Kenya*Korea (Rep.)

7 Kuwait*KyrgystanLaosLatvia*LebanonLesoth oLiberia*Libya*Liechtenstein*Lithuania*L uxembourgMacao*Macedonia*MadagascarMalaw iMalaysiaMaliMaltaMauritania*MauritiusMe xico*/**Moldova*MonacoMontenegroMontserr at*/**MoroccoMozambiqueMyanmar*NamibiaNe pal*NetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaragua*/**NigerNorwayOman*Paki stan*Panama*Papua New GuineaParaguay**Peru**PhilippinesPolandP ortugalQatar*RomaniaRussiaRwandaSt. Kitts & Nevis*/**St. LuciaSt. Vincent & the GrenadinesSan MarinoSao Tome & Principe*Saudi Arabia*SenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSlovenia*South AfricaSpainSri LankaSudan*SurinameSwazilandSwedenSwitze rland*SyriaTaiwanTajikistan*Tanzania*Tha ilandTogoTrinidad & Tobago**TunisiaTurkeyUgandaUkraine*Unite d Arab Emirates*United KingdomUruguay (Inter-American DrivingPermit only)Uzbekistan*Vatican City (Holy See)Venezuela**Vietnam*Western SamoaYemen*ZambiaZimbabwe* Not party to 1949 Convention.

8 INTERNATIONAL DRIVING PERMIT Honored.** driver s license and INTERNATIONAL DRIVING PERMIT recognized on presentation to local police and payment of Special Registration Fee upon arrival.**Geographical Areas Which Honor Inter-American DRIVING Permits (Convention on Regulation of Inter-American Motor Vehicle Traffic, Organization of AmericanStates, Washington, 1943) as of January, 2009. If you intend to drive in the following countries, be sure to check INTER-AMERICAN DRIVING PERMITbox page 1: Brazil and Uraguay.

9 (FOR OFFICE USE ONLY)Geographical Areas Which Honor INTERNATIONAL DRIVING Permits (Convention on Road Traffic, United Nations, Geneva 1949)as of January, 2009.