Form DS-1972D DRIVER LICENSE APPLICATION

Instructions

Who is eligible
For a driver license and/or a personal tax exemption card: an individual of a foreign mission or international
organization with privileges and immunities and their eligible family members. U.S. citizens, permanent residents and
local hires are not eligible.
When applying for a tax card only, OFM will accept an application only from applicants fully accredited by the O
F
Office of Protocol.
For a mission tax exemption card: a designated authorized user may be any person working for the mission; M
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
S
T
A
M
P
Class Type (Check one)

NOTE: Neither a tax exemption card nor a driver license will be issued to a child between the ages of 21 and 23 unless a student
justification form has first been submitted to the Office of Protocol. Eligibility ends on a child's 23rd birthday.

General Instructions
1. OFM will accept one application when applying for both a driver license or non-driver I.D. and a tax exemption card.

C - Regular License

M - Motorcycle

A - Commercial

2. Submit the application form with required attachments.

Testing requirement(s)

3. Please type and complete all items on the application. If an item does not apply enter "N/A". If questions are left blank, the

application will be returned for completion.
4. Attach two recent passport size color photographs of the individual (attach one photo in Block A and one photo to top of
application). All photographs should be (facial view) 1 1/2 inches high by 1 1/2 inches wide. The individual must 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.

Vision

Written/Legal/Law Test

Road/Skills Test
Vision Test Results
Left 20/

Right 20/

Both 20/

Item Instructions
Peripheral Vision
Select type of document(s) requested and indicate whether requesting an: Original for first time issuance, Renewal for an
#1.
With Lenses
Without Lenses
expiring document, or Replacement for lost or stolen driver license or tax card.
Enter Personal Identification Number (PID) as assigned by the Office of Protocol and Principal's PID if a
#2-5.
Written/Legal/Law Test
dependent. Fill in mission type with one of the following: Embassy, Consulate, US, OAS, World Bank, or IMF and country
represented
Passing Score
Passing Date
#6-10. Enter the individual's complete name, exactly as submitted to the Office of Protocol. Enter other information as requested.

Road/Skills Test
#11-13. Enter duty city and state, expected date or departure from the United States and predecessor.

NOTE:

Passing Score

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 the individual does not currently possess a driver license, provide certification that he/she has satisfied all requirements for a driver
license from the motor vehicle authority of the jurisdiction in which he/she lives.
#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 the individual wishes to operate. Attach a legible photocopy of his/her qualifications to operate such vehicles.

Examiner Signature and Date
Telephone Number

City/County/State
(MVA STAMP HERE)

#15-16.

Enter information as requested.

#17.

An individual who possesses a valid non-U.S. license may be required to obtain certification from the issuing motor vehicle
authority that all of its requirements for a license have been satisfied .

#18.

An individual who possesses a valid U.S. driver license may be required to take a vision test. The individual's current U.S.
license will be exchanged for a Department of State license.

DS-1972

Passing Date

Instruction Page 1 of 2

PRIVACY ACT STATEMENT
AUTHORITIES: The information is sought pursuant to Vienna Convention on Diplomatic Relations of 1961; Vienna Convention on Consular Relations of 1963; Diplomatic Relations Act (22 U.S.C.
254a-e); International Organizations Immunities Act (22 U.S.C. 288e (a)); Foreign Missions Act of 1982 (22 U.S.C. 4301-4316) as amended.
PURPOSE: The information solicited on this form will be used to adjudicate requests for driver license and tax exemption cards.
ROUTINE USES: The information provided on this form may be provided to other federal agencies for law enforcement, administrative or other statutorily authorized purposes as covered under STATE
36, Security Records. This information also may be provided to the employing foreign government or international organization.
DISCLOSURE: Providing this information is voluntary; Failure to provide the information requested on this form may result in denial of driver licenses or tax exemption cards.

PAPERWORK REDUCTION ACT STATEMENT
: *Public reporting burden for this collection of information is estimated to average 10 minutes per response, including time required for searching existing data sources, gathering the necessary
documentation, providing the information and/or documents required, and reviewing the final collection. You do not have to supply this information unless this collection displays a currently valid OMB
control number. If you have comments on the accuracy of this burden estimate and/or recommendations for reducing it, please send them to: M/OFM, 3507 International Place NW, Washington, DC
20008.

DS-1972

Instruction Page 1 of 2

U.S. Department of State

DRIVER LICENSE and TAX EXEMPTION CARD APPLICATION

OMB Approval No. 1405-0105
Expires: xx-xx-xxxx
Estimated burden: 10 minutes*

For Office Use Only (Shaded Area)
NAM

ADD

DOB

This application must be typewritten. Please read instructions on Page 1 before completing.

HGT

ACC
1.

Document(s) requested: Driver License

Non-Driver I.D.

Tax Exemption Card: Personal:

Mission:

Original

Original

Original

Original

Replacement
Renewal

Replacement
Renewal

Replacement
Renewal

Replacement
Renewal

RET

INP

LIT:

C

A

B

M

RES:

O

X

1

2

4

5

6

7

3

Worded Restrictions:
2. PID#:

3. Principal's PID#

4. Mission Type:

5. Country:
NLETS/AAMVA NET:

6. Name:
(Surname)
7. Address:

(First Name)

(Number and Street)
8. Date of Birth:
(MM/DD/YYYY)
11. Duty City/State:

(Middle Name)

(City)
9. Height:
9a. Weight:
(Pounds)
(Feet/Inches)
12. Expected Departure Date:
(MM/DD/YYYY)

Driver

(State)
10. Sex:
(M/F)
13. Predecessor:

Expiration date: (mm/dd/yyyy)

(Zip Code)

Exemption #:
Card Type:
Remarks:

(See Addendum 1)

(Only complete this section if applying for a driver license.)

14. Type of license requested:

Regular

15. Does driver wear corrective lenses for driving?

Motorcycle
Yes

Commercial/Bus

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

No

16. Does driver have any physical disability, other than vision, which may affect driving?
Yes
No
application a certificate from the driver's doctor indicating the onset of disability, diagnosis, prognosis, and medication, if any.

If yes, submit with this

17. Does driver possess a valid non-U.S. driver license?
Yes
No
If yes, indicate: Country
Expiration date:
(MM/DD/YYYY)
License #
(attach a legible photocopy of the non-U.S. license to this application).
18. Does driver possess a U.S. driver license?
Yes
No
If yes, indicate: State
Expiration date:
(MM/DD/YYYY)

(attach a legible photocopy of the U.S. license to this application).

License #

19. Has the driver's 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

No

If yes, give:

Date:

State
(MM/DD/YYYY)

Affix mission seal here:

WARNING

Signature of Certifying Official

This information is provided to the U.S. Department of State in accordance with
the requirements of United States law (Title 18, U.S. Code, Section 1001) that
all such statements are truthful. False information will be considered a violation
of U.S. law and, therefore, an abuse of the privileges and immunities to which
an individual's status may entitle him or her.

B. Sign in area below.

Title of Certifying Official

Date (mm-dd-yyyy)
DS-1972
xx-xxxx

Page 1 of 1

USE BLACK INK ONLY