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- Driving Licence Application Form - New South Wales
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Fillable Printable Driver License (DL) Application Form - Wisconsin
Fillable Printable Driver License (DL) Application Form - Wisconsin
Driver License (DL) Application Form - Wisconsin
Information about the Wisconsin
Driver License (DL) Application (form MV3001)
You will need to visit a DMV service center and present an MV3001 application when you:
•
apply for an original or duplicate* driver license or instruction permit
• renew an existing driver license
• apply for an occupational license
An application may only be submitted through the mail if you are unable to renew or obtain
a duplicate driver license because you are a Wisconsin resident who is temporarily out-of-state.
More information about:
•
•
•
* Note: You may be eligible to order a duplicate driver license online rather than visit a DMV service
center. See our online duplicate driver license application for further information.
renewing when out of state
applying for a license
fees
WISCONSIN DRIVER LICENSE (DL) APPLICATION
Wisconsin Department of Transportation
MV3001 2/2014 Ch. 343 Wis. Stats.
Acceptable proof of name and date of birth, legal presence, identity and Wisconsin residency are required.
APPLICATION COMPLETION REQUIREMENTS
ALL applicants, complete the top section on back.
If under age 18, also complete the ‘UNDER AGE 18’ section below.
CDL applicants, complete the ‘CDL APPLICANT ONLY’ section below.
Your Federal Medical Certificate is required unless you drive a school
bus or drive for a political subdivision.
DONOR
Check the box if you wish to help others by donating your organs,
tissue and eyes upon your death. Your gift will be used to save and improve
lives through transplantation, therapy, research or education. If you are at
least 18, checking the box indicates your legal consent for donation. You do
not have to answer this question to obtain a license.
ADA
The Wisconsin Department of Transportation complies with the
Americans with Disabilities Act (ADA).
SOCIAL SECURITY NUMBER (SSN)
If you have a SSN, you must
provide it (s. 343.14(2)(bm) Wis. Stats.). Your SSN may be used for
purposes authorized by law and to link your driver license and vehicle
registration records. Your SSN must correspond with the number issued by
the Social Security Administration. Federal regulation 49 CFR, Part 383.153
requires a SSN for commercial driver license privileges.
NOTICE TO MALES AGE 18–25
By submitting this application, you
consent to be registered with the Selective Service System, if required
by Federal law. You also authorize the Department of Transportation to
forward any information contained in this application that is requested by
the Selective Service System for the purpose of registering you as provided
in s. 343.14(2)(em) and s. 343.234 Wis. Stats.
WARNING
Any applicant for a driver license who presents fraudulent
or altered documents or makes a false statement to the issuing officer or
agency, may be subject to a fine of not more than $1,000, imprisonment for
not more than six months or both. The driver license privilege may also be
revoked for one year. (s. 343.14(5) Wis. Stats.)
OPT OUT
Under Wisconsin open records laws, WisDOT must provide
information from its records to requesters. If you do not want your name
and address included in requests we receive for ten or more records, you
may ask WisDOT to withhold your name and address from those lists by
checking the box on the application.
INSURANCE
No person may operate a motor vehicle in Wisconsin unless
the owner or driver of the vehicle has liability insurance in effect for the vehicle
being operated and carries proof of insurance whenever driving. Failure to
have insurance could result in a fine up to $500. Refer to s. 344.61-344.65
Wis. Stats. for full details.
An unexpired Wisconsin
driver license is acceptable
photo ID for voting.
(
s. 5.02(6m) Wis. Stats.)
COMMERCIAL DRIVER LICENSE APPLICANT ONLY
If applying for a HAZMAT endorsement (HME), complete Driver License Hazardous Materials Endorsement Application, form MV3735.
If applying for a school bus endorsement, complete School Bus or Alternative Vehicle License Information Request, form MV3740.
6. Is the vehicle you will be operating equipped
with air brakes?
YES
NO
7. Do you meet all the driver qualifications as required
by 49 CFR 391 to operate a commercial vehicle?
If not, see Motor Carrier Safety FAQs, publication
BDS218.
YES
NO
8.
School Bus, CDL Instructional Permit and
New CDL Class/Endorsement Applicants Only.
Is the vehicle in which you will take the commercial
driver license skills test representative of the type
of vehicle you will operate or intend to operate?
YES
NO
9.
School Bus Applicants Only.
Have you been convicted of an offense identified
on School Bus or Alternative Vehicle License
Information Request, form MV3740 in Wisconsin
or any other jurisdiction? If yes, list date and place:
YES
NO
1. In the past 5 years, have you had a loss of
consciousness or muscle control caused by a
neurological condition, for example, seizure disorder?
YES
NO
2. In the past 2 years, have you taken insulin
to control a diabetic condition?
YES
NO
3. In the past 2 years, have you taken oral
medication to control a diabetic condition?
YES
NO
4. Is your hearing impaired? (hard of hearing)
YES
NO
5. Have you held a valid operator's license in the
last 10 years from any jurisdiction (state) other
than Wisconsin?
If yes, list all states:
YES
NO
DRIVER LICENSE APPLICANT UNDER AGE 18 ONLY
Applicant Certification: I certify that in the past six months I have not
been ticketed for a moving violation that has or may result in a conviction.
I understand that falsifying this statement will result in the cancellation of
my probationary license. Applicant Signature – REQUIRED.
Sponsor Certification: As the adult sponsor under s. 343.15 Wis. Stats.,
I accept liability and verify that the minor is not a habitual truant and meets the
educational requirements for licensure. If required for this application, I certify
that the applicant has accumulated at least 30 hours of driving experience,
10 of which were at night.
X
Minor Name – Print
School Certification: I certify that this applicant is enrolled in approved
behind-the-wheel training which begins no later than 60 days from date signed.
Sponsor Name – Print Relationship to Applicant
School ID Number School Name Sponsor Wisconsin DL/ID Number Sex Birth Date (mm/dd/yyyy)
X
Official WisDOT Test Results
(line out if not used)
(Sponsor Signature – Must be Witnessed by DMV Agent or Notarized)
Knowledge Test Highway Sign Test
State of Wisconsin County of Subscribed and sworn to before me on this date
Pass Fail Pass Fail
X X
(Authorized School Official/Instructor Signature) (Date Signed)
(DMV Authorized Agent or Notary Signature) (My Commission Expires)
DO NOT Use Notary Seal
ALL APPLICANTS – Please Print
Social Security Number Applicant Name – First, Middle, Last Birth Date (mm/dd/yyyy)
Residence Address – Street Apt # City State ZIP Code County of Residence
Mailing Address – ONLY IF DIFFERENT from Residence Apt # City State ZIP Code County of Residence
Sex Race Eyes Hair Weight Height Former Name (if changed since last license or ID card)
OFFICE USE ONLY
Reason for Reissue:
Date Processor ID
REAL ID
Product Type
REGI
CDLI
CYCI
SPRI
JUVI
MPDI
PROB
RGLR
OCCL
SPRR
JUVP
NON
Wisconsin or Out-of-State License Number State Expiration Date
Legal Presence Name/DOB Proof Identity/SS Proof Residency Proof Application Type
ORG
RNW
DUP
REI
RSM
AMD
COA
Hearing (CDL Only) Driver Education
P
C
Class(es) Issued
A
B
C
D
M
Behind The Wheel School Name School ID Endorsements
H
N
P
S
T
F
Examiner ID Skill Test Score Highway Signs Knowledge Federal Medical Certificate Shown
YES Expires:
NO
X
Payment Amount
Check
Cash
CC
Acct. $
(Processor Signature) (Processor ID)
1. Do you wish to register to be an organ, tissue and eye donor?
Will you donate $2 to organ, tissue and eye donation efforts?
YES
YES
Reason for Name Change
Marriage Divorce Other List:
2. OPT OUT – Do you wish to have your name and address
withheld from lists WisDOT sells?
YES
6. Do you need glasses or contact lenses
for driving?
YES
NO
3. Has your license, ID card or operating privilege ever been
revoked, suspended, cancelled, disqualified or denied?
If yes, list date and place:
YES
NO
7. In the past year have you had a loss of
consciousness or muscle control caused
by any of the following conditions?
If yes, check condition(s) and list date(s):
YES
NO
4. Have you been convicted of operating while intoxicated
OUTSIDE of Wisconsin?
If yes, give date and place:
YES
NO
Traumatic Brain
or Head Injury (2)
Stroke (2)
Muscle
or
Nerve (2)
Mental (3)
Seizure
Disorder (4)
Diabetes (5)
Heart (6)
Lung (7)
5. Do you hold a valid driver license/identification card
FROM ANOTHER STATE/COUNTRY?
If yes, list:
Years of licensed driving experience in the United States,
its territories and Canada. List:
YES
NO
8. Check ONLY ONE of the following three boxes.
I certify that I am a:
U.S. Citizen
Permanent or Conditional Permanent Resident
Temporary Visitor
I certify that the information on this application is true under penalty
of perjury and I am a resident of Wisconsin.
(s. 343.14(5) Wis. Stats.)
9. I am a veteran registered with WDVA and wish to
have my veteran status indicated on my driver license.
(DMV is required to verify your status with WDVA.)
YES
X
(Applicant Signature) (Date)
VISION
Check if vision section completed by DMV Examiner
Visual Acuity Without RX With RX
Temporal Field of
Vision In Degrees
Recommended Restrictions or Comments, or Indicate (NONE):
Right Eye 20/ 20/
Left Eye 20/ 20/
Being duly licensed to practice
Optometry
Medicine, In
Wisconsin, or
Other
Corrective lenses required while driving
YES
NO
Color Perception
Normal
Deficient
Name of State or Country
Progressive eye disease or cataracts
YES
NO
If Yes, to Progressive eye disease
or cataracts
one eye
both eyes
I certify that the findings are correct
and I examined this applicant on: __________________________
(Exam Date)
Describe:
X
(Eye Examiner Signature) (License #)
WISCONSIN DRIVER LICENSE (DL) APPLICATION
Page 2 of 2
Wisconsin Department of Transportation
MV3001 2/2014 Ch. 343 Wis. Stats.
