Cbp Form 823f - Fast Commercial Driver Application - Mx

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DEPARTMENT OF HOMELAND SECURITY
U.S. Customs and Border Protection
FAST Commercial Driver Application - MX
Approved OMB No. 1651-0121
Exp. 1-31-2014
Please type or print
1a. (Check one box only)
First time applicant
Renewal
1b. Border crossings most frequently used (Example, Laredo)
Replacement
If renewal or replacement, current FAST Card No:
SECTION A - PERSONAL INFORMATION
2. Last/Paternal Name
2a. Maternal name
3. First name
4. Middle name (in full)
4a. Suffix
(yyyy/mm/dd)
5. Other names used (e.g., maiden name, former name)
Nickname
6. Gender
7. Date of birth
Male
Female
8.
City
Country
State
Place of birth
9. Citizenship (Check all that apply.)
10. Residence
Canadian citizen
U.S. citizen
Mexican citizen
Other (Must Specify)
Canada
United States
Mexico
11. Proof of citizenship/residency/immigration status (Attach copies)
U.S. Alien Registration No.
or
Border Crossing Card No.
Birth Certificate No.
Passport No.
(Expiration Date)
Country of Issuance
(yyyy/mm/dd)
Other
Type of document
No.
(Expiration Date)
(yyyy/mm/dd)
Drivers license No.
(Attach Copy)
State and Country of Issuance
(Expiration Date)
(yyyy/mm/dd)
SECTION B - ADDRESS HISTORY FOR THE LAST 5 YEARS
12. Current address
(yyyy/mm)
13. Street Address
Apt. No.
14. City
15. Colonia/Neighborhood
As of what
date?
17. State
18. Postal/Zip Code
19. Home telephone
16. Country
20. Business telephone/Cell phone number
Ext.
Mailing address if different from residential address
21. Street Address
Apt. No.
22. City
23. Colonia/Neighborhood
24. Country
25. State
26. Postal/Zip Code
Previous residential addresses if current residence is less than five years (address history continued on page 4).
(yyyy/mm)
(yyyy/mm)
27.
28. Street Address
Apt. No.
29. City
From:
To:
30. Colonia/Neighborhood
31. Country
32. State
33. Postal/Zip Code
(yyyy/mm)
(yyyy/mm)
34.
35. Street Address
Apt. No.
36. City
From:
To:
37. Colonia/Neighborhood
38. Country
39. State
40. Postal/Zip Code
(yyyy/mm)
42. Street Address
43. City
41.
(yyyy/mm)
Apt. No.
From:
To:
45. Country
46. State
44. Colonia/Neighborhood
47. Postal/Zip Code
Paperwork Reduction Act Statement: An agency may not conduct or sponsor an information collection and a person is not required to respond to this
information unless it displays a current valid OMB control number and an expiration date. The control number for this collection is 1651-0121. The estimated
average time to complete this application is 40 minutes. If you have any comments regarding the burden estimate you can write to U.S. Customs and Border
Protection Office of Regulations and Rulings, 799 9th Street, NW., Washington DC 20229.
CBP Form 823F (07/10)

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