Licence
Registration Renewal Notice
Certificate of Conditional Registration and Label
Unregistered Vehicle Permit (UVP)
Customer number Attachments
Office use only
Proof of Identity: To apply for a replacement product you must provide acceptable proof of identity documents. Details of acceptable proof of identity
documents are available from Roads and Maritime Services website at rms.nsw.gov.au, visit any service centre or registry or call us on 13 77 88.
Reference Statement: This is required in certain cases. See 4 below.
Poor picture
quality
Lost
Change of
conditions
Stolen
Damaged /
Destroyed
Not received
No
5.
Yes
Give details
2.
Residential address (licence address must be within NSW)
Customer details
Since last obtaining your licence, have you been
prohibited or refused from driving a motor vehicle/
vessel or riding a motorcycle in NSW or elsewhere?
Since last obtaining your licence, have you been
disqualified, cancelled, suspended or is there a charge
pending against you or is your licence subject to an
appeal for driving, riding or Maritime boating offences?
Your licence number
For a replacement licence go to Q2.
For a Certificate of Registration, Registration Label,
Registration Renewal Notice, Certificate of Conditional
Registration, Certificate of Approved Operations, Unregistered
Vehicle Permit (UVP) or a Classic Vehicle log book go to Q7.
Certificate of Registration Registration Label
Certificate of Approved Operations
1.
Name
Postcode
Date of birth
day month year
Licence - What is the reason for your application for a
replacement licence?
Change of
appearance
6.
No
Yes
Give details
Replacement Application
/ /
Page 1 of 2
Change
of name
Change of
residency status
Licence
confiscated
Licence previously
surrendered
(Roads and Maritime may verify permanent residency status online with the
Department of Immigration and Border Protection. For more information see
our website)
Signature of referee
day month year
/ /
Date
Other
Catalogue No. 45070182 Form No.1018 (03/2017)
I declare that I have known the applicant for at least 12 months and,
that to the best of my knowledge, the personal details given in 1 are
correct.
I understand that Roads and Maritime will collect and hold my
personal information to verify the applicant's details and that failure
to supply full details and sign this declaration can result in the
transaction not proceeding.
Roads and Maritime may disclose my personal information inside
and outside NSW to verify and validate the contents of this
application and any supporting documents. I have a right to access
or correct my personal information in accordance with the
provisions of the relevant privacy legislation. I declare that the
details in this reference are true and complete.
Referee's licence number Referee's daytime contact no.
A
Licence
Reg n
B
Classic Vehicle log book
PostcodeState
Mailing address
(if different from residential address, all mail will be
posted to this address)
Please read carefully before you sign.
If you do not tell the truth in your reference statement,
both you and the applicant can be fined.
(Please specify below)
Change specs
condition
4.
Required when sufficient proof of identity documents are not provided and
you still wish to pay for a replacement licence in which case the referee will
be contacted before a payment may be accepted. If payment is accepted you
will be given an interim receipt for your licence until you return to the registry
and produce acceptable proof of identity documents to obtain a photo-licence.
To be completed by a person 18 years and over who has known you for at
least 12 months and holds a current NSW licence or NSW Photo Card.
Reference Statement
Referee's full name (Please print)
Email address
Mobile number
Passenger
Transport
condition
Would you like a NSW Photo Card issued with your
NSW driver licence?
(Fees may apply. Additional application form not required)
3.
5yr
No
Yes 10yr
UNCLASSIFIED
SENSITIVE: PERSONAL
Please read carefully before you sign. If you do not tell the truth you
can be fined. Any licence you hold could be cancelled.
Roads and Maritime is collecting your personal information for your
application and may retain and use it for driver licensing, motor
vehicle and road transport or safety purposes.
You are required to provide your personal information under the
road transport legislation and we may refuse your application if you
do not provide it. We may disclose your personal information to
other driver licensing and vehicle registration agencies, to assess
your application or verify the information you provide, and for
inquiries about motor accidents.
Additionally, where you provide personal information concerning the
registration of a vehicle we may disclose that to confirm any
compulsory third party (bodily injury) insurance is current, to anyone
proposing to acquire an interest in your vehicle, in respect of
inquiries relating to stolen or abandoned vehicles, and to any joint
registered operator of your vehicle.
We may disclose your health information to assess your application
or to verify it. Otherwise we will not disclose your personal
information without your consent unless authorised by law. Your
personal information will be held by us at 20-44 Ennis Rd, Milsons
Point NSW 2061 and you can contact us to request to access or
correct it.
You declare that the information on this form is true and complete.
Under the road transport legislation it is an offence for anyone to
attempt to obtain or renew a driver licence or to register or renew
the registration of a vehicle, by false statement or any
misrepresentation or other dishonest means.
Page 2 of 2Catalogue No. 45070182 Form No.1018 (03/2017)
Representative's signature Date
Capacity if representative of company or firm
day month year
/ /
I wish to apply for a replacement:(tick appropriate box)
Certificate of
Approved Operations
Unregistered
Vehicle Permit
Registration Label
(Heavy vehicle more than 4.5
tonnes gross vehicle mass only)
Conditional Registration
Certificate and label
Registration Certificate
Registration Renewal Notice
What is the reason for your application?
Damaged
Not received
Your vehicle plate number or
VIN/chassis/serial number
Lost
Stolen Defaced
Destroyed
7.
FaultyChange of details
Privacy Statement and Declaration8.
(continued from previous column)
Classic Vehicle log book
Signature Date
Capacity if representative of company or firm
day month year
/ /
Mailing address checked on DRIVES (if applicable)
Note: This authority cannot be used to apply for a replacement licence.
I declare that the person named below is my authorised
representative.
Representative's Authority
Signature
Date
day month year
/ /
Driver licence number
Representative's details
Date of birth
day month year
/ /
Surname
Given names
PostcodeState
Address
Continued next column
Office Use - BUNDLE A Licensing / B Registration
Proof of Identity Record
Stand alone or primary proof Secondary proof
Document number Secondary proof issue or E/Date
POI Sample Questions completed
Verified
Referee contact
Confirm identity (Applicant's signature)
Eyesight test/Medical report (for changes to spectacles/passenger
transport conditions)
Pass with glasses or
contacts
Further checks required
(receipt issued)
Applicant's identity confirmed
Pass without glasses
or contacts
Unnecessary
Eyesight/Medical Report
Mismatched
No stored image Matched
NSW Photo Card
Registration, Conditional Registration or UVP issued
Registration Label Registration Certificate
CSR signature (who did POI and/or eyesight test and issued
replacement document)
Faulty
Registration Renewal
Notice
Unregistered Vehicle
Permit
Photo Comparison
Conditional Registration
Certificate of Approved
Operations
Conditional Registration
Certificate and Label
Staff number Date
day month year
/ /
Classic Vehicle log book
Commercial
Private
NSW Photo Card issued (No application form required)
UNCLASSIFIED
SENSITIVE: PERSONAL
RMS ABN 76 236 371 088 Catalogue No. 45070182 Form No.1018 (05/2012) Page 1 of 2
UNCLASSIFIED
SENSITIVE: PERSONAL
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome