Fillable Printable Driving Licence Application Form - New South Wales

Driving Licence Application Form - New South Wales

The information given in this application form is correct at the time of printing

but is subject to change without notice.

Learner Licence

- Car, tractor, implement, light rigid vehicle and medium rigid vehicle.

Driver Licence

Office Use

National Heavy Vehicle

Driver Licence

Motorcycle Rider Licence

A current overseas passport.

An Australian naturalisation or citizenship document issued by the

Department of Immigration and Citizenship or the Department of Immigration

and Border Protection.

The following documents issued by the Department of Immigration and

Citizenship or Department of Immigration and Border Protection:

List 1

List 2

a current Certificate of Identity

A Roads and Maritime issued NSW photo driver licence or NSW Photo Card

that has been expired more than 2 years but less than 5 years. The licence

must display a card number and not have been revoked or be reported as

lost, stolen or destroyed.

A current photo driver licence from another Australian State or Territory or

one that expired within the last two years. If your interstate licence shows

your middle name(s) as initial(s), you will require another supporting List 1 or

List 2 document showing your full name.

A current photo identity card for the NSW Police Force, excluding civilian

staff or family.

A current consular photo identity card issued by the Department of Foreign

Affairs and Trade.

a current Document of Identity

- Vehicles with 3 or more axles and more than 8 tonnes gross vehicle mass.

Page 1 of 4

Proof of Identity (To be produced each time you attend a registry or a service centre.)

To get a New South Wales licence you must prove your identity. You can use your current Roads and Maritime Services issued NSW photo driver licence

or NSW Photo Card or one which expired within the last two years. If you do not have this you must use one document from each of the lists below. Your

name should be the same on both documents. Your gender should be the same on both documents, if gender is shown. A copy of the brochure

'How to prove who you are' is available from your nearest registry or service centre.

NOTE: All documents from list 1 and 2 must be originals (photocopies are not acceptable) and at least one of them must show your signature. If you do

not have a document showing your signature you must complete question 18 on this form. Your photo will be stored on Roads and Maritime database.

An Australian full birth certificate showing parental details issued by the NSW

Registry of Births, Deaths and Marriages. Note: Commemorative certificates

are not acceptable (except for 1987 and 1988 NSW Historic Birth

Certificates).

An overseas birth certificate showing parental details provided a passport or

an official Australian travel document is also shown.

A current Australian passport or one that expired within the last two years.

Validation with Australian Passport Office may be required for passports

issued within the last 2 years.

The following travel documents issued by the Department of Foreign Affairs

and Trade:

A current Medicare card, Pensioner Concession Card, Department of

Veterans' Affairs entitlement card, or any other current entitlement card

issued by the Commonwealth Government.

A current plastic credit card, or account card issued by a bank, building

society, credit union, American Express or Diners Club International,

showing your name and signature.

A passbook or account statement up to one year old, issued by a bank,

building society, credit union, American Express or Diners Club International.

An account statement must show your name, residential or mailing address

and account number, as well as the financial institution's letterhead or stamp.

A telephone (landline only), gas or electricity bill up to one year old.

A water rates, council rates or land valuation notice up to one year old.

A current student identity card, displaying the student's photograph, issued

by an Australian secondary school, TAFE or university. Where a student

identity card has an issue date, but no expiry date, it may be accepted up to

two years from the date of issue.

Evidence of enrolment at an Australian secondary school, TAFE or university

up to one year old showing the student's name and address and on the

institution's letterhead.

A current Mobility Parking Scheme (MPS) permit issued by Roads and

Maritime with or without a photo.

A current Roads and Maritime issued NSW photo Firearm, Security Industry

or Commercial Agents and Private Inquiry Agents operator licence.

A current photo identity card for the Australian Defence Force, excluding

civilian staff or family.

Licence Application

(You must live in NSW to be issued with a NSW Licence)

Proof of Residential Address If none of your proof of identity

documents shows your current address, you must produce one of the

following documents showing your current address: a current certificate of

vehicle registration issued by Roads and Maritime; a driver licence or

vehicle registration renewal notice for the coming period issued by Roads

and Maritime; a contract of sale, lease arrangement or rental receipt for

your place of residence up to two years old. All documents must be

originals.

Reference Statement If you cannot provide proof of your residential

address you must provide a reference statement at question 17 on this

form.

Change of Name If you have changed your name, you need to provide

one of the following documents: marriage certificate (for NSW marriage

certificates Roads and Maritime will only accept those issued by the

RBDM); divorce document bearing the name reverted to; deed poll

registered with the relevant authority; change of name certificate issued

by the RBDM; full birth certificate showing the name at birth and the new

name; a completed Instrument Evidencing Change of Name form which

has been registered in the Land Titles Office or a Permanent Resident

Evidence (PRE) ImmiCard. Your identity and change of name documents

should show a clear link between your names. All documents must be

originals.

Translations If a document is not in English it must be accompanied by

an official translation by the Community Relations Commission of NSW.

Roads and Maritime also accepts translations from the Free Translating

Service provided by the Department of Social Services (DSS) or

previously the Department of Immigration and Citizenship. The Free

Translating Service is only available for eligible people. For information

on this service please go to the DDS website: www.dss.gov.au/free-

translating

International Drivers If you are a visiting overseas driver and you want

to obtain a NSW licence for the first time and if you want the tenure

on your overseas licence recognised you must declare it and you may

be required to provide further documentary evidence. Licences issued

to temporary overseas visitors will be marked with a 'Q' to denote

that 'Evidence of permanent resident status not provided'.

For more

information see our website at rms.nsw.gov.au or the brochure 'Guide for

International Drivers'.

Permanent Australian residency must be supported by acceptable

documentary evidence or verified online by Roads and Maritime. For a

full list of acceptable proof of Australian residency documents, see our

website.

Free Licences If you hold a current NSW Pensioner Concession Card

(PCC), a Centrelink Confirmation of Concession Card Entitlement form

stamped PCC, or a Department of Veterans' Affairs (DVA) Gold Card

endorsed 'TPI' or 'EDA' or 'War Widow' or 'War Widower', or a DVA letter

or statement certifying a disability pension of 70% or more, an

Intermediate pension, or an assessment at 50 or more impairment points,

you may be eligible for a free licence. A current interstate licence may be

transferred to a NSW licence free of charge.

Eyesight, Knowledge, Driving and other Tests, Medical and Learner

Driver Log Book requirements You may be required to undergo an

eyesight test, knowledge test and in some cases a medical examination.

You may also need to do a driving test or undertake heavy vehicle

competency based assessment. Some applicants may be required to

pass a Hazard Perception Test and/or a Driver Qualification Test. Rider

training or a riding skills test may be needed if you apply for a motorcycle

licence. A Learner Driver Log Book may also be issued when you obtain

a learner driver licence.

Enquiries If you have any enquiries about applying for a licence, visit our

website at rms.nsw.gov.au, call us on 13 22 13, contact a registry or

service centre. Hearing or speech impaired? Call us on the National

Relay Service: TTY users phone 13 36 77 then ask for 13 22 13. Speak

and Listen users phone 1300 555 727 and ask for 13 22 13.

Please note If you hold a Mobility Parking Scheme permit you may have

to supply a medical report before your licence is issued or renewed. This

will not be necessary if your licence is already subject to medical review

by Roads and Maritime.

a current Titre de Voyage

a Visa Evidence Card

a Document for Travel to Australia (up to 5 years from the date of issue

on the accompanying visa)

Attachments

Customer number

Catalogue No. 45070018 Form No. 1001 (05/2015) ABN 76 236 371 088

Evidence of Immigration Status (EIS) ImmiCard (current or expired)

Permanent Residence Evidence (PRE) ImmiCard

Residence determination (RDI) ImmiCard

We no longer record organ donation details. For more information visit donatelife.gov.au

Please note: If you answer Yes to any question from 9(a) and (b)

to 12 you may be required to provide a completed Roads and

Maritime medical form. Contact 13 22 13 to obtain a medical form.

Family name

Residential address (must be in NSW)

Personal details

Postcode

Given name(s)

Pensioner / Interstate - eligible for a free licence or transfer?

Postal address - if different from residential address

Postcode

No Yes

Give details

Have you ever been disqualified, prohibited or refused from

driving a motor vehicle/vessel or riding a motorcycle in NSW or

elsewhere?

What class of licence are you applying for?8.

State, Territory or Country

Licence number

10. Have you ever had attacks or giddiness, blackouts, fainting or

other sudden periods of unconsciousness?

11. Do you have any medical, physical or mental disabilities which

may affect your driving?

Yes

Give details and bring the most recent

licence, or documentary proof with you.

Do you hold, or have you ever held, a licence or proof of such a

licence, issued by another State, Territory or Country?

No Yes

First issue date For vehicle types

Expiry date

Light rigid

Medium rigid

Car

Motor

cycle

Multi combination

(B-double or road train)

Heavy rigid

Heavy combination

Yes

If it was issued by an Australian State or Territory it must be

surrendered. The issuing authority will be advised and the licence

destroyed.

If information needs to be verified, checks may take a number of

days.

if you have held your driver or motorcycle rider licence for less

than 3 years, you will receive a NSW provisional P1 or P2 licence.

(Motorcycle rider P2 exemptions may apply)

If you have held any other licence not already declared please

indicate the issuing State, Territory or Country.

You may be required to show

documentary evidence of this licence.

(Pensioner status must be validated online)

Date of birth

maleGender: female

Mobile number (if you would like to receive communications)

Email address

Note:

you may be issued with a NSW provisional licence if your full first

issue date is not displayed on your licence or documentary proof.

Day Month Year

What is your last date

of entry in Australia

Are you an Australian citizen or a permanent resident of

Australia?

Yes

you may be issued with a NSW learner licence if your overseas

licence cannot be validated.

Are you an Aboriginal person or Torres Strait Islander?

This question is optional. Do not tick either box if you do not

wish to answer it.

Answering this question is voluntary. Roads and Maritime may use

this information to develop driver licensing and vehicle registration

services for Aboriginal people. Roads and Maritime will not disclose

this information without your consent unless authorised by law.

Yes

Day Month Year

No Yes

Day Month Year

/ /

Evidence required. (Roads and Maritime may verify permanent

residency status online with the Department of Immigration

and Border Protection. For more information see our website).

Give details

Do you hold or have you ever held a licence to drive

or ride or a NSW Photo Card/Proof of Age Card in NSW in the

above name or in another name?

Class of licence

Licence/Customer number

Yes

Expiry date

Other name

Day

Month

Year

/ /

Please provide your email address if you would like to register for an

online service account, go to service.nsw.gov.au/online-services

for more information.

6. Do you have a disqualification, cancellation, suspension or

pending charge against you in NSW or elsewhere or is your

licence subject to an appeal for driving, riding or Maritime

boating offences?

Give details

No Yes

Page 2 of 4Catalogue No. 45070018 Form No. 1001 (05/2015) ABN 76 236 371 088

9. Do you have (a) diabetes?

(a) No

Yes

Controlled by:

Insulin (Oral medication

(eg tablets)

or (b) epilepsy?

Diet

(medical not required)

(b) No

Yes

What are they

13.

Do you have an eye or vision condition that may affect your

driving? eg monocular vision, double vision, visual field

defects, poor night vision.

If witnessed by a parent or guardian they must attend our

registry with you and show proof of their own identity.

Witness to applicant's signature18.

Required when you cannot provide an acceptable

proof of identity document that shows your signature.

Signature of applicant

Name of applicant (block letters)

Witness declaration

Signature of witness

Date Daytime contact phone of witness

Business address of witness

(can be residential address of parent/guardian)

Name of witness (block letters)

Postcode

Position of witness - Employer / school principal / bank manager /

parent / guardian (cross out those not applicable)

I certify that the applicant, whose name and signature appears

above, has signed in the signature box above in my presence.

My personal information is being collected for verification of the

applicant's signature. It will be held by Roads and Maritime at 101

Miller Street, North Sydney NSW 2060. My witnessing of the

applicant's signature is voluntary. My personal information held by

Roads and Maritime may be disclosed inside and outside NSW to

verify the contents of this application.

glassescontact lensesYes

Please read carefully before you sign. If you do not tell the truth

you can be fined. Any licence you hold could be cancelled.

Privacy Statement and Declaration 16.

Signature

Date

Roads and Maritime is collecting your personal information for your

application for a driver licence and may retain and use it for driver

licensing, motor vehicle and road transport or safety purposes.

We are entitled to obtain your personal and health information under

road transport legislation and may refuse your application if you do not

provide it.

We may disclose your personal information to other driver licensing

and vehicle registration agencies; to assess your application or verify

the information you provide and for inquiries about motor accidents.

Additionally, where you provide personal information concerning the

registration of a vehicle we may disclose that; to confirm any

compulsory insurance is current; to anyone proposing to acquire an

interest in your vehicle; in respect of inquiries relating to stolen or

abandoned vehicles and to any joint registered operator of your

vehicle.

We may disclose your health information to assess your application or

to verify it. Otherwise we will not disclose your personal or health

information without your consent unless authorised by law.

Your personal and health information will be held by us at 101 Miller

Street, North Sydney NSW 2060 and you can contact us to request

to access or correct it.

You declare that the information on this form is true and complete.

Under road transport legislation it is an offence for anyone to attempt

to obtain or renew a driver licence by false statement or dishonest

means.

Provide an eyesight report from an optometrist or doctor.

Yes

Will you be wearing glasses or contact lenses when driving or

doing the eyesight test?

15. Does wearing prescription glasses or contact lenses correct or

control this condition?

No Yes

Day Month Year

Go to 15

/ /

14.

Go to 16

Day Month Year

/ /

Signature of referee Date

I declare that I have known the applicant for at least 12 months and,

that to the best of my knowledge, the personal details given in

Question 1 are correct.

I understand that my personal information is being collected for

verification of the applicant's personal details. It will be held by

Roads and Maritime at 101 Miller Street, North Sydney NSW 2060.

My supply of referee's statement is voluntary. Roads and Maritime

may disclose my personal information inside and outside NSW to

verify the contents of this application.

Day Month Year

/ /

Reference17.

To be completed by a person who has known you for at least 12 months and

holds a current NSW unrestricted licence. We may contact the referee to verify

information in this application.

Required when you cannot provide proof of residential address.

Referee's full name (Please print)

Referee's licence number

Referee's daytime contact

telephone number

Please note: If you do not tell the truth in your reference

statement, both you and the applicant can be fined.

12.

What are they?

No Yes

Do you regularly use drugs (such as stimulants or drugs of

addiction) other than prescription medication, which may affect

your driving?

Page 3 of 4Catalogue No. 45070018 Form No. 1001 (05/2015) ABN 76 236 371 088

Interpreter's signature

Confirm identity - Applicant's signature Confirm identity - Applicant's signature

Confirm identity - Applicant's signature

Secondary proof

Stand-alone or primary proof

Document number

POI seen-

Signature of reg/SNSW and Staff number

Stand-alone or primary proof

Passport/Visa - date of issue or E/D

Document number

Passport/Visa - date of issue or E/D

POI seen-

Signature of reg/SNSW and Staff number

Proof of identity (must be produced with each visit)

Secondary proof - date of issue or E/D Secondary proof - date of issue or E/D

POI seen-Signature of reg/SNSW and Staff number

Document number

Stand-alone or primary proof

Passport/Visa - date of issue or E/D

Secondary proof - date of issue or E/D

Parent or Guardian Proof of Identity

Type of proof Type of proof

Type of Proof

Proof of residential address

Type of proof

Name of interpreter - if used

Eyesight test/Medical report

Driving test

Pass with glasses

or contacts

Pass without

glasses or contacts

Interpreter's signature

Knowledge Test / Hazard Perception Test / Driver Qualification Test (cross out whichever is not applicable)

Name of interpreter - if used

Testing officer's signature

Eyesight test given - Signature of reg/SNSW and Staff number

Interpreter's authority Interpreter's authority

Confirm identity - Applicant's signatureConfirm identity - Applicant's signature

Test supervisor's signature and Staff number Test supervisor's signature and Staff number Test supervisor's signature and Staff number

Testing officer's signature Testing officer's signature

Issued licence

Licence issued-reg/SNSW Signature and Staff Number

Licence number Type DateClass

Medical

report

Secondary proof Secondary proof

Date

Name of interpreter - if used

Interpreter's signature

Interpreter's authority

Confirm identity - Applicant's signature

Photo Comparison

No stored image

or not requested

MismatchedMatched

Office Use

First NSW issue or Upgrade/Reissue

Eyesight

report

Pass Fail DatePass Fail DatePass Fail

DatePass Fail DatePass Fail DatePass Fail

Page 4 of 4Catalogue No. 45070018 Form No. 1001 (05/2015) ABN 76 236 371 088

RMS ABN 76 236 371 088 Catalogue No. 45070018 Form No. 1001 (11/2011) Page 1 of 4

Page 1 of 4Catalogue No. 45070018 Form No. 1001 (11/2012) ABN 76 236 371 088