APPLICATION FOR INTERNATIONAL DRIVING PERMIT
or
INTER-AMERICAN DRIVING PERMIT FEE FOR EACH PERMIT $15.00
Issuance of Permit is restricted to persons EIGHTEEN YEARS or over who hold a valid U.S.A. or Territorial License. PERMIT VALID FOR ONE YEAR. Not
renewable.
CHECK DESIRED PERMIT
International Driving Permit
(Fee $15.00 and 2 Passport Type Photos signed on back)
Inter-American Driving Permit *** (see reverse side)
(Fee $15.00 and 2 Passport Type Photos signed on back)
MANDATORY REQUIREMENTS
1. Attach 2 recent signed Passport Type Photos (2" x 2") SIGNED ON BACK
2. Enclose permit fee of $15.00 (NO CASH)
3. If mailing application, a photocopy of U.S. Driver's License must accompany completed application. (both sides)
OPTIONAL REQUIREMENTS
1. Additional postage in U.S. funds for expedited return mail (see USPS.com for rates)
NOTE: IT IS IMPORTANT THAT YOUR U.S.A. OR TERRITORIAL LICENSE BE CARRIED WITH THE PERMIT AT ALL TIMES.
The International or Inter-American Permit is not valid for driving in the United States.
PRINT NAME IN FULL. (MUST MATCH LICENSE EXACTLY) Mr. Mrs. Ms. (Circle One)
FIRST MIDDLE LAST
PHONE HOME STREET ADDRESS
CITY STATE ZIP CODE
US DRIVER'S LICENSE NO. STATE OF ISSUE EXPIRATION DATE
BIRTHPLACE: CITY STATE OR COUNTRY BIRTHDATE (MO DAY YEAR)
DATE PERMIT TO BE EFFECTIVE DEPARTURE DATE FROM U.S.
FOREIGN ADDRESS (IF KNOWN)
PLEASE CHECK THE APPROPRIATE BOX BELOW TO INDICATE THE TYPE OF VEHICLE FOR WHICH YOU NOW HOLD A VALID U.S.A. OR
TERRITORIAL DRIVER'S LICENSE, AND FOR WHICH YOU DESIRE THIS PERMIT:
MOTORCYCLE PASSENGER CAR VEHICLE OVER 7,700 LBS. VEHICLE OVER 8 SEATS VEHICLE WITH HEAVY TRAILER
I CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND CORRECT, AND THAT THE LICENSE INDICATED HAS NOT BEEN SUSPENDED NOR REVOKED.
I FURTHER CERTIFY THAT I UNDERSTAND THAT A VALID STATE DRIVER'S LICENSE MUST ACCOMPANY THIS PERMIT, AND THAT THIS PERMIT IS VALID ONLY AS LONG AS
THE STATE LICENSE IS VALID, BUT NOT TO EXCEED ONE YEAR FROM THE DATE THE PERMIT IS ISSUED.
SIGNATURE (signature mandatory for issuance of Permit)
_______________________________________________________________________________
DATE
_________________________
