Skill Performance Evaluation Certificate Application Form Page 2
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25The following information must be submitted with your skill performance
evaluation (SPE) certificate application packet:
1. An unilateral SPE certificate application.
2. A driver employment application.
3. A copy of the results of your medical examination report (medical long form).
4. A copy of your medical examiner’s certificate.
5. A medical evaluation summary completed by either a board qualified or board
certified physiatrist (doctor of physical medicine) or orthopedic surgeon.
6. A copy of the road test and road test certificate or a copy of both sides of your
commercial driver’s license (CDL).
7. A copy of your State motor vehicle driving record (MVR) for the past 3 years
from each State in which you held a driver’s license or permit.
8. A copy of your SPE certificate or waiver of certain physical defects issued by
individual State(s), where applicable.
Incomplete application packets will be returned. Please review the above
requirements before mailing to ensure that all requested information has been
included in your SPE certificate application packet. Mail your SPE certificate
application packet to the medical program specialist in the service center for the
State in which you are a legal resident.
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