Form Cdl-102 - Cdl Certification For Military Waiver Of Skills Test Page 2
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2PART 2 - COMMANDING OFFICER’S CERTIFICATION
Name of CO: _________________________________________________________________________________________
Address: _____________________________________________________________________________________________
Telephone: (_____) ____________________
Applicant’s Date of Qualification: from ________________________________ to __________________________________
Mark a “4” in the box for the class(es) of vehicle(s) that the applicant operates and for the applicable endorsements:
o
o
o
o
o
o
o
o
Vehicle Class:
A
B
C
Endorsements:
T
P
N
H
X
Experience Operating Commercial Motor Vehicles
Mark a “4” in the box for the type(s) of vehicles the applicant has been driving:
o
o
o
Tractor-trailer
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Air brake equipped?
. . . . .
Yes
No
o
o
o
Truck-trailer (truck over 26,000 lbs.)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Air brake equipped?
. . . . .
Yes
No
o
o
o
Truck-trailer (truck does not exceed 26,000 lbs.)
. . . . . . . . . . . . . . . . . . . . .
Air brake equipped?
. . . . .
Yes
No
o
o
o
Single Vehicle
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Air brake equipped?
. . . . .
Yes
No
o
o
o
Vehicle designed to transport 16 or more persons including the driver
. . . .
Air brake equipped?
. . . . .
Yes
No
o
o
o
Vehicle designed to transport 8 - 15 persons including the driver
. . . . . . . .
Air brake equipped?
. . . . .
Yes
No
Class A Vehicle - Any combination of vehicles with a GCWR of 26,001 pounds or more, provided the
GVWR of the vehicle being towed is in excess of 10,000 pounds GVWR. This includes tractor-trailer
and truck-trailer.
Class B Vehicle - Any single vehicle with a GVWR of 26,001 pounds or more, or any such vehicle towing
a vehicle not in excess of 10,000 pounds GVWR.
Class C Vehicle - Any single vehicle or combination of vehicles that does not meet the definition of Class A or Class B,
but that is designed to transport 16 or more people including the driver or is placarded for
hazardous materials.
Endorsements:
T - Doubles/Triples
P - Passengers
N - Tankers
H - Hazardous Materials
X - Hazardous Materials and Tankers
I certify that the applicant named in Part I is/was assigned in a job/assignment requiring operation of a commercial motor vehicle
and that the information I have provided is correct.
IMPORTANT: Making a false statement in any license or non-driver ID card application, or in any proof or statement in connection
with it, or deceiving or substituting, or causing another person to deceive or substitute in connection with such application, may
subject you to criminal prosecution for a misdemeanor or felony under the Vehicle and Traffic Law and/or the Penal Law.
Print Name/Rank: ____________________________________________ Date: _____________________
ç
________________________________________________ Date: _____________________
Signature:
Authority of Article 136, Uniform Code of Military Justice or 10 U.S.C. 1044A
CDL-102 (4/16)
PAGE 2 OF 2
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