Application For Military Skills Test Waiver Form Page 2
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2COMMANDING OFFICER’S CERTIFICATION OF COMMERCIAL DRIVING EXPERIENCE
TELEPHONE NUMBER
COMMANDING OFFICER’S NAME (LAST, FIRST, MIDDLE)
STREET ADDRESS
CITY
STATE
ZIP CODE
COUNTY
SERVICE MEMBER’S DATE OF QUALIFICATION:
FROM
TO
SERVICE MEMBER’S NAME
EXPIRATION DATE (US Gov’t Motor Vehicle
Operator Identification Card / License)
Circle
the highest class of vehicles the service member has been driving:
Class
Vehicle Description
EXAMPLE OF VEHICLES IN GROUP
th
* 5
WHEEL
-
Truck Tractor/Semitrailer
Any combination of vehicles with a GCWR of
A
26,001 or more pounds provided the GVWR
of the vehicle(s) being towed is in excess of
10,000 pounds.
* PINTLE HOOK - Truck Trailer Combination
Any combination of vehicles with a GCWR of
A
26,001 or more pounds provided the GVWR
of the vehicle(s) being towed is in excess of
10,000 pounds.
B
Any single vehicle with a GVWR of 26,001 or
more pounds or any such vehicle towing a
vehicle not in excess of 10,000 pounds
GVWR.
The vehicle the service member operates is equipped with a full air brake system:
YES
NO
The vehicle the service member operates is equipped with an air-over-hydraulic braking system:
YES
NO
The transmission in the vehicle the service member operates is:
AUTOMATIC
MANUAL
I certify that the service member named on the front of this document is/was assigned in a job/assignment requiring the operation of a
commercial motor vehicle, the service member’s driving experience has been verified; and the information provided herein is true and correct
to my knowledge, information and belief. I also certify that I am an officer of the Armed Forces with the authority to administer oaths; and
who has the general powers of a notary public.
PRINT COMMANDING OFFICER’S NAME/RANK
DATE
SIGNATURE
DATE
Authority of Article 136, Uniform Code of Military Justice or 10 U.S.C. 1044a
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