Affidavit Of Competency - Wyoming Department Of Transportation printable pdf download

Affidavit Of Competency - Wyoming Department Of Transportation

AFFIDAVIT OF COMPETENCY

The affidavit of competency form may be used by a driver who has verifiable experience driving a non-commercial heavy

vehicle (GCWR and/or GVWR of 39,001 or more pounds) to waive the skills test required to add a “Z” endorsement to a

Wyoming class “C” license pursuant to W.S. 31-7-109(h)(viii)(B).

APPLICANT INFORMATION

FULL LEGAL NAME (please print)

DATE OF BIRTH (must be at least 18 years old)

APPLICANT SIGNATURE

DATE

VEHICLE DESCRIPTION

(Applicant, please initial below)

______ Any single or combination of vehicles with a gross vehicle/combined weight rating (GVWR/GCWR) of

39,001 or more pounds.

CERTIFICATION OF DRIVING COMPETENCY

CERTIFIER FULL LEGAL NAME

CONTACT PHONE NUMBER

ADDRESS (including city, state, zip)

DRIVER LICENSE NUMBER

STATE

CLASS & ENDORSEMENTS

I certify under penalty of perjury that the applicant named above has tested for or is capable of operating a heavy vehicle

as checked in the “Vehicle Description” section of this form and that said applicant’s driving experience has been verified

by me. I also certify that I am qualified to certify this applicants driving competency, as I am currently licensed to operate

a vehicle of this weight (GCWR and/or GVWR of 39,001 or more pounds).

CERTIFIER SIGNATURE

DATE

APPLICANT MVID #

**WYDOT USE ONLY**



APPLICANT VERIFICATION

CERTIFIER VERIFICATION

 Class A or B license OR

 Class C license with “Z” endorsement

 Over 18

(DL Issue date ___________________________)

DRIVER LICENSE EXAMINER SIGNATURE

DATE

Wyoming Department of Transportation (WYDOT) - Driver Services

5300 Bishop Boulevard, Cheyenne, WY 82009-3340

Affidavit of Competency (6/22/2015)

Phone: 307-777-4800 Fax: 307-777-4803

WYDOT – DRIVER SERVICES

Affidavit Of Competency - Wyoming Department Of Transportation