PRINTABLE APPLICATION

Please print this form, fill out and send it with your payment to:

For official use only

Attention: additional charge $5.00 will apply if you fillout printable application by hand

no any additional charges if you apply online at

INFORMATIONAS PRINTED ON YOUR NATIVE DRIVER LICENSE
First name: |___|___|___|___|___|___|___|___|___|___|___|___|___|___|
Last name: |___|___|___|___|___|___|___|___|___|___|___|___|___|___|
Address: |___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|
|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|
City: |___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|
State/Province: |___|___|___|___|___|___|___|___|___|___|___|___|___|
ZIP/Post Code: |___|___|___|___|___|___|___|___|___|___|___|___|
Country: |___|___|___|___|___|___|___|___|___|___|___|___|___|___| / MAILING ADDRESS (LEAVE BLANK IF THE SAME)
First name: |___|___|___|___|___|___|___|___|___|___|___|___|___|___|
Last name: |___|___|___|___|___|___|___|___|___|___|___|___|___|___|
Address: |___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|
|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|
City: |___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|
State/Province: |___|___|___|___|___|___|___|___|___|___|___|___|___|
ZIP/Post Code: |___|___|___|___|___|___|___|___|___|___|___|___|
Country: |___|___|___|___|___|___|___|___|___|___|___|___|___|___|
Date of Birth: _____|_____MM______|_____DD______|______YY
Country of Birth: |___|___|___|___|___|___|___|___|___|___|___|___|___|
Gender(male, female) : __F___|___M____| (CIRCLE)
Eye color: |___|___|___|___|___|___|___|___|___|___|___|___|___|
Height: |___|___|____| CM |___| FEET |___| INCHES
DRIVER’S LICENSE # |___|___|___|___|___|___|___|___|___|___|___|
Exp. Date: _____|_____MM______|_____DD______|______YY
Category : |_A_| MOTORCYCLES
|_B_| PASSENGER CARS
|_C_| VEHICLES OVER 7,700 Lbs
|_D_| VEHICLES OVER 8 SEATS
|_E_| VEHICLES OF B,C, OR D with other that a light trailer
|___| NON GOVERNMENTAL ID CARD

To order an International Translation of Driver’s License for more than a one year validity period you represent that your driver’s license will either be valid for such a period, automatically renewed or will renew your license in your country of origin. Validity periods maintain your validity status provided that the native original driver’s license is valid for that same period / CONTACT INFORMATION
E-Mail: |___|___|___|___|___|___|___|___|___|___|___|___|___|____|___|
Phone: |___|___|___|___|___|___|___|___|___|___|___|___|
1 YEAR VALIDITY - $35.00
3 YEARS VALIDITY - $40.00
5 YEARS VALIDITY - $45.00
10 YEARS VALIDITY- $50.00
10 YEARS VALIDITY (GOLDEN WITH ELECTRONIC CHEAP) - $110
5 YEARS NON GOVERNMENT ID CARD - $25.00
INSURANCE FOR ALL OF IDL’s- $7.99
INSURANCE FOR GOLDEN IDL - $14.99
HANDLING THIS APPLICATION - $5.00
International Shipping Rates Prices
DHL International $ 45.00
USPS Regular Mail $5.00 (3-4 weeks of delivery, trucking# is not available)
United States Shipping Rates Prices

USPS Priority mail $6.00
USPS Priority mail ( trackable ) $ 8.00
USPS Express mail (Within USA) $ 19.00
UPS / FedEx Next Day Guarantee (Within USA) $ 26.00
Payment method
Money order #______

Personal or Company Check #______

Western Union #______Sender’s First and Lastname______

Credit or Debit card
Name on the credit card|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|
Card #:|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___| Exp. date:|___|___| |___|___|___|___|
VISA, MASTERCARD, AMERICAN EXPRESS, DISCOVER MONTH YEAR
For MasterCard or Visa the 3-digit CVVwhich |___|___|___|___| can be found after the account number on the back of the card
Billing Address of CC |___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|
|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|

I, the client, confirm that my native driver’s license is valid, issued by a government entity, not subject to revocation or suspension. I acknowledge that my International Translation of Driver’s License is not a standalone document, and must be go together with by my valid native driver’s license. I acknowledge that it is my obligation to verify with the local authority the rights to use a translation of my native driver’s license.
Note: Applications without payment or credit card info cannot be processed
Be sure met all requirements for International Translation of Driver License:
1. Signed Application |___|
2. One Photo (any sizes) |___|
3. Copy of Native Driver License (both sides) |___|
4. Payment |___|
Do not forget include in payment shipping cost and $5 for handle this application
ATTACH ONE COLOR PHOTO (ANY SIZES)
/ SIGNATURE HERE (WRITE CLEARLY BELOW)
ATTACH COPY OF YOUR NATIVE DRIVER LICENSE