Get Identification Card Louisiana Form

Do you wear contact lenses or glasses when driving I certify that I am the custodial parent legal domiciliary parent legal guardian of the minor applying and this is my authorization to the Office of Motor Vehicles to issue a license/identification card as indicated above. I also declare by my signature below that information furnished by minor and me is complete and correct. Signature of person authorized to sign in accordance with R.S. 32 407. NOTE Only the domiciliary parent can sign if joint custody has been awarded. License/ID Number Signature First Middle/Maiden Last Printed Name Notary Public Signature Seal COMPLETE FOR NAME CHANGE PROPER DOCUMENTATION MUST BE ATTACHED NAME ON LICENSE/ID NAME CHANGE TO DECLARATION OF INTENT By my signature affixed below I certify under penalty of law that 1 all statements on this application are true and correct 2 I have obtained Louisiana registration on all vehicles I intend to operate in the State of Louisiana 3 I have and will maintain vehicle liability insurance or security on all owned vehicles as required by R.S 32 861-865 4 I may be subject to certain criminal and/or civil penalties for offenses involving a commercial motor vehicle or a commercial driver s license if I am the operator of such motor vehicle or the holder of such license 5 I meet the qualifications of 49 CFR 391 for interstate operation of a commercial motor vehicle if applicable 6 I am in compliance with the CMV Safety Act of 1986 I do not and will not have in my possession more than one controlled dangerous substance in my blood while operating a motor vehicle if required to do so by a law enforcement officer. TEMPORARILY RESIDING OUT OF STATE APPLICATION FOR RECONSTRUCTED DUPLICATE/RENEWAL LICENSE/ID CARD LOUISIANA DEPARTMENT OF PUBLIC SAFETY AND CORRECTIONS OFFICE OF MOTOR VEHICLES SELECT ONE OF THE FOLLOWING RENEWAL REQUEST - EXPIRED LICENSE/ID CARD DUPLICATE REQUEST LOST OR STOLEN LICENSE/ID CARD MUST BE COMPLETED LICENCE/ID NUMBER IF KNOWN DATE OF BIRTH MM/DD/YY RACE/SEX HEIGHT PRINT FULL NAME EYES LAST SOCIAL SECURITY NUMBER DAYTIME PHONE NUMBER OPTIONAL FIRST MIDDLE/MAIDEN OR SUFFIX TEMPORARY OUT OF STATE ADDRESS APARTMENT NUMBER IF APPLICABLE CITY/TOWN STATE ZIP PERMANENT LOUISIANA RESIDENCE ADDRESS MUST BE ANSWERED YES NO 1. Are you a United States Citizen 2. Have you ever experienced any loss of consciousness other than normal sleep If yes please explain 3. Do you currently have any physical or mental condition which could impair your ability to operate a motor vehicle safely 4. Do you wear contact lenses or glasses when driving I certify that I am the custodial parent legal domiciliary parent legal guardian of the minor applying and this is my authorization to the Office of Motor Vehicles to issue a license/identification card as indicated above. I also declare by my signature below that information furnished by minor and me is complete and correct. Signature of person authorized to sign in accordance with R*S* 32 407. NOTE Only the domiciliary parent can sign if joint custody has been awarded* License/ID Number Signature First Middle/Maiden Last Printed Name Notary Public Signature Seal COMPLETE FOR NAME CHANGE PROPER DOCUMENTATION MUST BE ATTACHED NAME ON LICENSE/ID NAME CHANGE TO DECLARATION OF INTENT By my signature affixed below I certify under penalty of law that 1 all statements on this application are true and correct 2 I have obtained Louisiana registration on all vehicles I intend to operate in the State of Louisiana 3 I have and will maintain vehicle liability insurance or security on all owned vehicles as required by R*S 32 861-865 4 I may be subject to certain criminal and/or civil penalties for offenses involving a commercial motor vehicle or a commercial driver s license if I am the operator of such motor vehicle or the holder of such license 5 I meet the qualifications of 49 CFR 391 for interstate operation of a commercial motor vehicle if applicable 6 I am in compliance with the CMV Safety Act of 1986 I do not and will not have in my possession more than one controlled dangerous substance in my blood while operating a motor vehicle if required to do so by a law enforcement officer.