Form Dl 64 I - Certificate Of Completion - Instructions
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1I
DL 64
(07/01/2013)
Virginia Driver Training - CDL Skills Test
Certificate of Completion (DL 64)
INSTRUCTIONS
Purpose:
Use this document as a guide for completing the Certificate of Completion (DL 64)
1. TEST SUCCESSFULLY
Date driver successfully completed skills test
COMPLETED DATE
DRIVER INFORMATION
1. DRIVER FULL
Full legal name; no nicknames or abbreviations
LEGAL NAME:
2. DRIVER CUSTOMER
Number shown on driver's license
NUMBER
3. BIRTHDATE:
Date of birth (example: 07/11/1991)
4. GENDER
Check box for M (male) or F (female)
VEHICLE TYPE AND ENDORSEMENT INFORMATION
Vehicle Class
1. CHECKBOX CLASS A
Check to indicate student is certified to operate this class vehicle
CHECKBOX -
Check to indicate student has O restriction
NO TRACTOR-TRAILER
2. CHECKBOX CLASS B
Check to indicate student is certified to operate this class vehicle
3. CHECKBOX CLASS C
Check to indicate student is certified to operate this class vehicle
Endorsements
1. CHECKBOX-S
Check to indicate school bus endorsement (16 or more occupants)
2. CHECKBOX-P
Check to indicate passenger bus endorsement (16 or more occupants)
3. CHECKBOX-VEHICLE
Check to indicate vehicle with air brakes
WITH AIR BRAKES
4. CHECKBOX FULL AIR
Check to indicate no restriction
5. CHECKBOX AIR OVER
Check to indicate Z restriction
HYDRAULIC
4. CHECKBOX - NO
Check to indicate hydraulic only - K restriction
AIR BRAKES
5. RESTRICTIONS BOX
Third party tester/DMV examiner lists restrictions that should appear on CDL license
CERTIFICATION
Third Party Tester
1. COMPANY NAME:
Name of Third Party Tester company
2. CERTIFICATION CODE
7-digit DMV number assigned to Tester
3. EXAMINER FULL
Print Third Party Tester examiner's full legal name
LEGAL NAME
4. SIGNATURE
Third Party Tester examiner signs
5 DATE
Date examiner signs certificate
DMV
1. FULL LEGAL NAME
Print DLQA examiner full legal name
2. LOGON ID
DLQA DMV logon ID
2. SIGNATURE
DLQA examiner signs
3. DATE
Date DLQA examiner signs certificate
4. FULL LEGAL NAME
Print CSC Representative full legal name
2. LOGON ID
CSC Representative DMV logon ID
5. SIGNATURE
CSC Representative signs
6. DATE
Date CSC representative signs certificate
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