Driver License Application Intrastate Driver Certification
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2TEXAS COMMERCIAL DRIVER LICENSE APPLICATION
INTRASTATE DRIVER CERTIFICATION
NOTICE: All information on this application must be in INK.
In order to obtain a Commercial Driver License (CDL), which authorizes the operation of a commercial motor vehicle in intrastate
commerce, you must certify to and meet the qualifications from Federal Rule 49 C.F.R., Part 391/390, and Texas Transportation Code,
Chapter 522. If you meet these requirements, certify to Section A, B, or C below.
APPLICANT INFORMATION
LAST NAME
FIRST NAME
DATE OF BIRTH (mm/dd/yyyy)
DRIVER LICENSE NUMBER
SOCIAL SECURITY NUMBER
WHAT IS INTRASTATE COMMERCE?
Transportation of property (a commodity) where the point of origin and destination are totally within one state and no state line
or international boundary is crossed. The driver does not cross state lines or international boundaries when operating a commercial
vehicle.
The Bill of Lading will be an indicator as to whether a shipment or commodity is interstate or intrastate. Transporting cargo that
always came from and stays within the state of Texas is considered intrastate cargo.
If there is no Bill of Lading, the origin and destination of the shipment will be an indicator.
Examples include, but are not limited to:
School bus drivers who only transport passengers within Texas.
Drivers who only transport and deliver goods to and originate from Texas addresses.
INSTRUCTIONS
Read each section carefully and certify only to the one section that applies to you. You may not certify to more than one section.
If you certify to this form, you will have a restriction placed on your CDL, restricting you to intrastate commerce only.
If you certify to Section A, you must choose option A or B.
If you certify to Section B, you must provide a valid medical certificate.
If you certify to Section C, you may choose one or both options, however the appropriate restriction(s) will be placed on your CDL.
CERTIFICATION
I certify that I:
a. Am at least 18 years of age, and
b. Am not disqualified to drive a motor vehicle in any state
SECTION A. I FURTHER CERTIFY THAT I: (CHECK THE APPROPRIATE BOX IF APPLICABLE)
YES NO
a.
Am a driver who operates a commercial motor vehicle in intrastate commerce, not transporting property requiring a hazardous
materials placard, and was regularly employed operating a commercial motor vehicle in Texas prior to August 28, 1989 and
am not required to meet the medical standards set forth in the federal Motor Carrier Safety Regulations, OR
b.
Am a driver who operates a commercial motor vehicle in intrastate commerce, not transporting property requiring a hazardous
materials placard, and was regularly employed operating a commercial motor vehicle in Texas prior to August 28, 1989. While
I am not required to meet the medical standards set forth in the federal Motor Carrier Safety Regulations, I am seeking to obtain
or maintain employment as a school bus driver, and therefore I understand that I must undergo and pass an annual physical
examination as required by Texas Transportation Code Section 521.022. I further understand that I am required to keep a
current medical examiner’s certificate with me at all times while operating a school bus.
IF YOU HAVE SELECTED YES FOR SECTION A, YOU MEET THE FEDERAL SELF-CERTIFICATION CATEGORY 4, EXCEPTED
INTRASTATE (49 C.F.R. PART 383.71(b)(1)(iv)). A MEDICAL EXAMINER’S CERTIFICATE IS NOT REQUIRED TO BE PRESENTED FOR THE
ISSUANCE OF THIS CDL.
I CERTIFY THAT I OPERATE OR EXPECT TO OPERATE A COMMERCIAL MOTOR VEHICLE IN INTRASTATE COMMERCE ONLY.
I ENGAGE OR WILL ENGAGE EXCLUSIVELY IN TRANSPORTATION OR OPERATIONS THAT EXEMPT ME FROM BEING
REQUIRED TO MEET THE MEDICAL STANDARDS OF 49 C.F.R. PART 391. I FURTHER CERTIFY THAT I HAVE READ,
UNDERSTAND, AND MEET THE PRECEDING QUALIFICATIONS.
APPLICANT’S SIGNATURE
DATE
CDL-5 (Rev. 11/14)
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