Form DS-1972 U.S. Department of State Driver License & Tax Exemption

OMB Approval No. 1405-0105
Expires 06-30-08
Estimated Burden: 30 Minutes

United States Department Of State
DRIVER LICENSE and TAX EXEMPTION CARD Application
This application must be typewritten. Please read instructions on reverse before completing.

4 5 6 7
Worded Restrictions:

Commercial/ Bus
15. Do you wear corrective lenses for driving?
Yes
No16. Do you have any physical disability, other than vision, which may affect your driving? Yes
NoIf yes, submit with
this application a certificate from your doctor indicating the onset of disability, diagnosis, prognosis, and medication, if any.
17. Do you possess a valid non-U.S. driver license? Yes
No
If yes, indicate: Country
Expiration date:
(attach a legible photocopy of your non-U.S. license to this application).
18. Do you possess a valid U.S. driver license? YesN
o If yes, indicate: State
Expiration date:
I
I
(attach a legible photocopy of your U.S. license to this application).
19. Has your U.S. license or privilege to operate a motor vehicle been suspended, revoked, cancelled, or refused by any state or by any
jurisdiction within the United States? Yes
NoIf yes, give: Date:
State-

Affix mission seal below:
Signature of certifying official
Title of certifying official

A. Peel off adhesive cover and
place color photo here:

WARNING
This informatiorz is provided to the U.S. Departmerzt of State in
accordance with the requirernerzts of United States law (Title IS, U.S.
Code, Section 1001) that all such statements are truthful. False
inforrnation will be considered a violation of U.S. law and, therefore, an B. Sign in area below.
abuse of the privileges and immunities to which an individual's status
may entitle him or her.

Date
In accordance with 5 CFR 1320 5(b), persons are not required to respond to the collection of
this information unless this form displays a currently valid OMB control number.

USE BLACK INK ONLY

Instructions to Applicant
who May Apply
For a driver license andlor a personal tax exemption card: an individual of a foreign mission or international organization with
privileges and immunities and their eligible family members may apply. U.S. citizens, permanent residents or local hires may not apply.
When applying for a tax card only, OFM will accept an application only from applicants fully accredited by the Office of Protocol.
For a mission tax exemption card: a designated authorized user may be any person working for the mission; individuals not employed
by the mission cannot be an authorized user of a mission card. A separate application must be submitted for each authorized user.

This space reserved for certifying
Motor Vehicle Authority Use Only

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NOTE: Children between the ages of 21 and 23 must submit a student justification form to the Office of Protocol prior to applying for
either a driver license or tax exemption card. Eligibility ends on an individual's 23rd birthday.
General Instructions
1. OFM will accept one application when applying for both a driver license or non-driverI.D. and a tax exemptioncard.
2. Submit the application form with required attachments.
3. Please type and complete all items on the application. If an item does not apply to you enter "N/A." If questions are left blank, the
application will be returned for completion.
4. Attach two recent passport size color photographs of yourself (attach one photo in Block A and one photo to top of application). All
photographs should be (facial view) 1 ?hinches high by 1 % inches wide. The Office of Foreign Missions can provide this service at no
charge. Sign Block B with black ink only.
5. For a tax exemption card complete items #1- 13. For a driver license complete items # 1- 19.
Item Instructions
#l.
Select type of document(s) you are requesting and indicate whether requesting an: Original for first time applicants, Renewal for
an expiring document, or Replacement for lost or stolen driver license or tax card.
#2-5. Enter your Personal Indentification Nunber (PID) as assigned by the Office of Protocol and Principal's PID if a dependent. Fill
in mission type with one of the Following: Embassy, Consulate, UN, OAS, World Bank, or IMF and country which you represent.
#6-10. Enter your complete name, exactly as submitted to the Office of Protocol. Enter other information as requested.
#11-13. Enter duty city and state, expected date of departure from the United States and predecessor.
NOTE: To replace a lost or stolen driver license or tax exemption card, the applicant must attach a diplomatic note to this
application. The note must state where, when, and how the card was lost or stolen.
Driver License Specific Instructions
If you do not currently possess a driver license, you must obtain certification that you have satisfied all requirements for a driver license
from the motor vehicle authority of the jurisdiction in which you live.
#14.
The regular Department of State driver license authorizes the bearer to operate a vehicle, a vehicle towing a trailer weighing no
more than 26,000 pounds gross vehicle weight, or a bus which seats no more than 15 occupants, including the driver. To operate
vehicles not authorized by the regular Department of State driver license, select the types of vehicles you wish to operate. Attach
a legible photocopy of your qualifications to operate such vehicles.
#15-16. Enter information as requested.
#17.
If you possess a valid non-U.S. license, you may be required to obtain certification from the motor vehicle authority of the
jurisdiction in which you live that you have satisfied all requirements for a license.
If you currently posses a valid U.S. driver license, you may be required to take a vision test. You will exchange your current U.S.
#18.
license for a Department of State license.

Class Type (Check One)
C - Regular License
A - Commercial

M - Motorcycle

Testing Requirement(s)
Vision
Written/LegalLaw Test
RoadISkills Test
Vision Test Results
Left 201Right 2 0 1 Both 201Peripheral Vision
With Lenses
Without Lenses
WrittenILegaVLaw Test
Passing Score
Passing Date
Road/Skills Test
Passing Score
Passing Date
Examiner Signature and Date
Telephone Number
City/County/State

(MVA STAMP HERE)