Form Chp 295j - Applicant/carrier Document Checklist
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1
2State of California
See page 2 for additional instructions.
California Highway Patrol
APPLICANT/CARRIER DOCUMENT CHECKLIST
CHP 295J (Rev. 2-16) OPI 061
Applicant Name/DL #:
Original and renewal applicants, and carriers of applicants applying to operate a school bus, school pupil activity bus
(SPAB), youth bus, general public paratransit vehicle (GPPV), farm labor vehicle (FLV), or vehicle for
developmentally disabled persons (VDDP), shall call the local California Highway Patrol (CHP) office to schedule an
interview with a CHP School Bus Officer or Coordinator (SBO/C). To avoid delays in the certification process,
applicants are required to bring the following documents to the interview. If all required documents are not submitted
during the interview, the missing documents must be presented at the time of testing. Check appropriate boxes
below.
□
□
□
□
□
□
School Bus
Youth Bus
SPAB
GPPV
FLV
VDDP
Special
Special
Special
Special
Special
Special
□
Certificate
Certificate
Certificate
Certificate
Certificate
Certificate
Application
Application
Application
Application
Application
Application
1.
(CHP 295)
(CHP 295)
(CHP 295)
(CHP 295)
(CHP 295)
(CHP 295)
□
Driver License,
Driver License,
Driver License,
Driver License,
Driver License,
Driver License,
Temporary
Temporary
Temporary
Temporary
Temporary
Temporary
License, or
License, or
License, or
License, or
License, or
License, or
2.
Permit
Permit
Permit
Permit
Permit
Permit
□
MCSA 5875,
MCSA 5875,
MCSA 5875,
MCSA 5875,
MCSA 5875,
N/A
Medical
Medical
Medical
Medical
Medical
Examination
Examination
Examination
Examination
Examination
3.
Report
Report
Report
Report
Report
MCSA 5876,
MCSA 5876,
MCSA 5876,
MCSA 5876,
MCSA 5876,
N/A
□
Medical
Medical
Medical
Medical
Medical
Certificate
Certificate
Certificate
Certificate
Certificate
4.
□
Training
Letter from
Training
Letter from
Training
N/A
Certificate
Employer (
Certificate
Employer
Certificate
or
Training Certificate
5.
for Youth Bus “B”)
First Aid
First Aid
□
Certificate
Certificate
N/A
N/A
N/A
N/A
(unless waived per
(unless waived per
6.
CVC 12522)
CVC 12522)
DMV Ten-year
DMV Ten-year
DMV Ten-year
DMV Ten-year
DMV Ten-year
DMV Ten-year
□
Driving History
Driving History
Driving History
Driving History
Driving History
Driving History
Print-out (H6)
Print-out (H6)
Print-out (H6)
Print-out (H6)
Print-out (H6)
Print-out (H6)
7.
(Original applicant
(Original applicant
(Original applicant
(Original applicant
(Original applicant
(Original applicant
only)
only)
only)
only)
only)
only)
□
Fees - $57
Fees - $57
Fees - $57
Fees - $57
Fees - $12
Fees - $57
($25
($25
($25
($25
($25
for DL 45 / $32 for
for DL 45 / $32 for
for DL 45 / $32 for
for DL 45 / $32 for
(
for DL 45 / $32 for
original / renewal
Background
Background
Background
Background
Background
applicants for
8.
Check)
Check)
Check)
Check)
Check)
DL 45)
Renewal
Renewal
Renewal
Renewal
Renewal
No Background
Applicant $12 only
Applicant $12 only
Applicant $12 only
Applicant $12 only
Applicant $12 only
Check required.
CHP 295J (Rev. 2-16) OPI 061 (PAGE 1 0F 2)
Chp295J_0216.pdf
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