IW-419 International Driver's License/ID Card …

1 A. Select International Drivers license and Options (if require) IDL Book and Magnetic Stripe Plastic Card +$48 Additional Magnetic Stripe Plastic Card +$15 No Magnetic Stripe Plastic Card (booklet only) -$15 Change Card to Regular (no magnetic strip) -$10 Additional Regular Plastic Card +$10 No Hologram Protection Seal for IDL Book -$10 International Driver's License/ID Card ApplicationIDLID Services, Tool free US/Canada: 1-800-608-9594 Other destinations: 1-416-800-8974 IW-419 (Rev. June 2012) Letter J See separate instructions on page 2 and sample on page 3. Make a copy for friends. Previous editions Office Use OnlyTYPE OR PRINT YOUR INFORMATION IN THE SPACE PROVIDED BELOW EACH ITEM.

2 PRINT CLEARLY!Part 1 Identification of Drivers License/ID Card Owner (will be printed on card)1. Surname (last name)2. Name (first name)5. State or Province (do not abbreviate)4. City or Town3. Street Address6. Zip or Code Postal7. Country (do not abbreviate)13. E-Mail8. Date of Birth ( Month - DD - YYYY )9. Gender (sex) Male Female12. Height ( cm or feets )10. Country of Birth (do not abbreviate)11. Eyes Color Gray Green Blue Black Brown HazelPart 2 Mailing Informatin (to this address your order will be mailed)18. State or Province (do not abbreviate)17. City or Town15. Name (first name)14. Surname (last name)16. Street Address19. Zip or Code Postal20. Country (do not abbreviate)B. Select Non Governmental ID Card (if require) Regular Non Governmental ID Card +$23 Add Magnetic Stripe to ID Card +$10 Add Additional ID Card (duplicate) +$15 Order Information (payment calculation and options)Part 3B 2.

3 Fill Non Governmental ID Card Type (country or state)(for ID Card only) (do not abbreviate)C. Select Mailing Option (mandatory) Regular Registered/Sertified Mail/all destinations available/(2-4 weeks) +$18 Domestic Priority Mail/US or Canada only/(2-3 days) +$26 International Priority Mail/read instruction for available countries/ (7-10 days) +$59 Domestic Express Mail/US or Canada only/(1-2 days) +$43 International Express Mail/read instruction for available countries/ (3-5 days) +$73 Total from section A $_____Part 3 aCalculate Total Price Total from section B $_____ Total from section C $_____ Total For Order to Pay $_____ + + =B 1. ID Card Validity Years (1 by default) 1 Year 2 Years 3 Years Part 4 Attach Photo Picture, Signature and Native Driver's license Copy Attach a Copy of Your Native Drivers license Here (for IDL mandatory, for ID card optionally) !

4 !DO NOT SEND ORIGINALS!!Sign in Angle !!DO NOT SIGN OVER LINE!!Staple or Glue Photo Here Passport Size from " " and more from 3x4 cm and more It will be Printed DigitallyPayment and Mailing (read carefully)Part 5O TARASOVA 793 CENTER STR., # 186 LEWISTON, NY, 14092 USA O TARASOVA 1750 THE QUEENSWAY., #3-103 ETOBICOKE, ON, M9C5H5 CANADA 1. I declare that I have examined the information on this form and to the best of my knowledge and belief it is true, correct, and complete. 2. I agree that I may not drive, anywhere without a valid original Driver's license , and my International Driver's license is not a standalone document. It must be accompanied by original Driver's license all time of driving. 3. I admit not to use these documents in purpose of breaking or violating the Select Convenient Address, Cut Proper Address Label, Stick it to Envelope and Mail to our Office Your Order will be Shipped on Next Business Day Upon Receipt1.

5 Please make the application clear. If application is filled with errors or incomprehensibly - reprinting fee will apply. 2. You must fill ALL fields. 3. Please pay exact amount as calculated in Part 3a. If You pay less amount as required, then product will be corrected to cheapest or application will not be processed till full payment received. 4. NO DISCOUNTS APPLY FOR PRINTABLE APPLICATION! 5. If You mail cash please use registered mail only. ALL PRICES IN US (United States of America) DOLLARS. For conversion rates to other currencies PLEASE EMAIL or CALL us. IF TOTAL AMOUNT IS NOT PAID IN FULL DUE TO OUR EXCHANGING RATE THEN ORDER WILL NOT BE PROCESSED. 6. MAKE CHECKS OR MONEY ORDERS PAYABLE TO: O TARASOVA. Some personal checks might stay on hold up to 30 days till payment is cleared. A t t e n t i o n22.

6 Cell Phone21. Home PhoneA 1. IDL Validity Years (1 by Default) 1 Year 3 Years 5 Years 10 YearsA 2. Driving Categories (For International Driver's license Only) A (Motorcicles) B (Regular Cars) C (Trucks) D (Buses) E (Trucks with Trailers) Instructions for Form IW-419 (Rev. June 2012, Letter J) Application For International Driver's License/ID CardPurpose of form. Printable version is provided only for persons who wants to obtain International Driver's license or non-governmental ID Card and has difficulties with completing application online on our web site By applying online you help us to provide better and faster service. To avoid misreading of handwriting and other mistakes, we kindly ask you to apply online (and you can still mail us your personal information such as Driver's license copy and signature sample).

7 Online application has also different options for payments. You can apply online and still mail your checks, money orders, cash, use western union, if that type of payments more convenient for you. General instructions. 1. To apply for International Driver's license you must have valid national Driver's license . You must provide a copy of your native Driver's license to us for order processing. must fill Your application clear and legible. If application is filled with errors or incomprehensibly - reprinting fee will apply. 3. You must fill ALL fields. 4. You must carefully select product that you order in Part 3 and calculate total in Part 3a. Pay exact amount as calculated in Part 3a. If You pay less amount as required, then product will be corrected to cheapest or application will not be processed till full payment received.

8 5. NO DISCOUNTS APPLY FOR PRINTABLE APPLICATION! Pay exact price as printed in application. All discounts available only for online application. Typing fee applied to printable application. 6. If You mail cash please use registered mail only. We are not responsible for non-delivered envelopes. All prices are in US (United States of America) dollars. For conversion rates to other currencies PLEASE EMAIL or CALL us. IF TOTAL AMOUNT IS NOT PAID IN FULL DUE TO OUR EXCHANGING RATE THEN ORDER WILL NOT BE PROCESSED. 7. MAKE CHECKS OR MONEY ORDERS PAYABLE TO: O TARASOVA. Checks with another name on it will not be processed. Some personal checks might stay on hold up to 30 days till payment is Part 1. This is personal information that will be printed on Your International Driver's license or ID Card. Fill first and last name only.

9 It can't be too long. If it will be too long - it will be corrected. Height may be filled either centimeters or feet with inches. Part 2. This is the address where your order will be mailed. Double check this address, otherwise your order will be returned to us. We use traceable mail with signature requirements. So You must provide address where someone stays all the time at home or after receiving notification you must visit postal outlet to pick up your postage. You can check the status of Your shipment on the website of the carrier you have selected. Tracing information will be e-mailed to you. Part 3. If You desire to order International Driver's license , You must select in section A "IDL Book and Magnetic Stripe Plastic Card" and select additions or substraction to it. If You order IDL - You must fill Subsection A1 and A2.

10 If You desire to order Non-Governmental ID Card, You must select in section B "Regular Non-Governmental ID Card" and select additions or substraction to it. If You order Non-Governmental ID Card - You must fill Subsection B1 and B2. In section B2 You must print - what kind of Non-Governmental ID Card do You require. This may be "state" or "country" ID only. For special id types like "Press ID" or "Native Americans" please contact us. ATTENTION: we DO NOT make any original documents forgery - do not ask us to forge any native state id, state drivers license , passports or ANY governmental issued documents. All this requests will be ignored. Part 4. To complete this part you must attach a copy of your native Driver's license if You apply for IDL and staple it to proper place.