Cdl Certification For Waiver Of Skills Tests Page 2
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1
2Part II – Command Certification (Please print)
Name of Commanding Officer:
Address:
Telephone:
Email address:
Applicants Date of Qualification
From:
To:
Mark an “X” in the square for the type(s) of vehicle(s) the employee operates:
A
B
C
T
N
H
X
Vehicle Class:
Endorsements:
(Indicate the highest level of class the employee has been driving)
Transfer of School Bus (S) and/or Passenger (P)
endorsements under this waiver program is prohibited
The vehicle the employee operates is equipped with full air brakes:
Yes
No
The vehicle the employee operates is equipped with an air-over-hydraulic braking system:
Yes
No
The transmission on the vehicle the employee operates is equipped with:
Standard
Automatic
I certify that the service member named on the front of this document is/was assigned in a
job/assignment requiring operation of a commercial motor vehicle; the service member’s driving
experience has been verified; and the information provided herein is true and correct to my
knowledge, information, and belief. I also certify that I am an officer of the U.S. Armed Forces with the
authority to administer oaths and that I have the general powers of a notary public.
Print Commanding Officer’s Name/Rank:
Date
Signature:
Date
Authority of Article 136, Uniform Code of Military Justice or 10 U.S.C. 1044A
Signatures must be originals. Photocopies are not acceptable.
Changes may not be made to this form once it is signed.
Class A Vehicle
Any combination of vehicles with a Gross Combination Weight Rating (GCWR) of 26,001
or more pounds, provided the Gross Vehicle Weight Rating (GVWR) of the vehicle being
towed is in excess of 10,000 pounds GVW R.
Class B Vehicle
Any single vehicle with a GVWR of 26,001 or more pounds, or any such vehicle towing a
vehicle not in excess of 10,000 pounds GVWR.
Class C Vehicle
Any single vehicle or combination of vehicles that does not meet the definition of Class A
or Class B, but is either designed to transport 16 or more people including the driver or is
placarded for hazardous materials.
Endorsements
T – Doubles/Triples
N – Tankers
X – Hazardous Materials and Tankers
H – Hazardous Materials
Page 2 of 2
CDL-004 (Revised 4/2016)
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