Form 447 - Application For S.c. Credential Page 2

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FOR COMMERCIAL DRIVER’S LICENSE ONLY

Yes

13. Have you read and do you understand and meet the qualification requirements under Federal Rule 49 CFR, Part 391 of the Federal Motor

Carrier Safety Administration rules to operate a commercial vehicle?

Yes

14. Are you subject to any disqualification listed in 383.51 of the Federal Motor Carrier Regulations?

Yes

15. Is the vehicle being operated on the road test representative of the class for which you are applying and intend to operate?

Yes

16. Do you have a valid D.O.T. medical examiner certificate for a Class A,B,C,E, or F license? Expiration Date

You must show the medical certificate as evidence and it must be updated every two years.

Yes

17. Are you a medically exempt government employee? If yes, give name of agency.

Any falsification of information on this application may result in a 60-day disqualification of your CDL and/or result in criminal prosecution

under state and federal law.

INSURANCE INFORMATION (Check and complete the statement that applies to you.)

Under penalties of perjury, I declare that I am insured with the following insurance company and will maintain liability insurance throughout the issuance period.

AGENT NAME _______________________________________ COMPANY NAME ______________________________________________

No motor vehicle required to be registered in South Carolina is owned by me or any relative residing in my household.

CONSENT FOR MINOR (Must be completed for all unemancipated applicants under the age of 18) I am a parent or guardian of the unemancipated minor

applicant. (If guardian, please provide documentation.) (Responsible adult must complete Form 447- CM)

Emancipated minors must submit one of the following as proof of emancipation:

Court Order

Certificate of Marriage

Active Military Orders

*Only the original or certified copies will be accepted.

I consent to the issuance of a beginner’s permit and/or driver’s license. I accept responsibility for the actions of the minor applicant as outlined in Section 56-1-110 of the South Carolina

Code of Laws. To be released from this responsibility before the applicant reaches age 18, I understand that I must submit a written request for release to the Department of Motor Vehicles

to have this application and the applicant’s beginner’s permit or driver’s license cancelled.

Relationship to Minor Applicant

Date

Printed Name

Signature

I CERTIFY under penalty of perjury that all information and statements made in this application are true and correct as of the date of this application.

I also CERTIFY that I do not have a valid driver’s license other than the one(s) reported in questions #3 and #4 and that my privilege to operate a motor vehicle is

not now or subject to be suspended, cancelled, revoked or disqualified at the time of this application.

I understand that I am receiving a S.C. credential based on the information provided on this application, and that SCDMV will verify all information. I also

understand that if my privilege to drive is ever suspended, cancelled or revoked in South Carolina or any other state, my S.C. license will be revoked until I have met

all reinstatement requirements in South Carolina and any other states.

Printed Name

Signature

Date

FOR OFFICE USE ONLY

Original

Duplicate

Route Restricted

Provisional

Exchanging Out-of-State Permit or License for a

Renewal

Reissue