WISCONSIN DRIVER LICENSE (DL) APPLICATION
Wisconsin Department of Transportation
MV3001 2/2014 Ch. 343 Wis. Stats.
Acceptable proof of name and date of birth, legal presence, identity and Wisconsin residency are required.
APPLICATION COMPLETION REQUIREMENTS
ALL applicants, complete the top section on back.
If under age 18, also complete the ‘UNDER AGE 18’ section below.
CDL applicants, complete the ‘CDL APPLICANT ONLY’ section below.
Your Federal Medical Certicate is required unless you drive a school
bus or drive for a political subdivision.
DONOR Check the box if you wish to help others by donating your organs,
tissue and eyes upon your death. Your gift will be used to save and improve
lives through transplantation, therapy, research or education. If you are at
least 18, checking the box indicates your legal consent for donation. You do
not have to answer this question to obtain a license.
ADA The Wisconsin Department of Transportation complies with the
Americans with Disabilities Act (ADA).
SOCIAL SECURITY NUMBER (SSN) If you have a SSN, you must
provide it (s. 343.14(2)(bm) Wis. Stats.). Your SSN may be used for
purposes authorized by law and to link your driver license and vehicle
registration records. Your SSN must correspond with the number issued by
the Social Security Administration. Federal regulation 49 CFR, Part 383.153
requires a SSN for commercial driver license privileges.
NOTICE TO MALES AGE 18–25
By submitting this application, you
consent to be registered with the Selective Service System, if required
by Federal law. You also authorize the Department of Transportation to
forward any information contained in this application that is requested by
the Selective Service System for the purpose of registering you as provided
in s. 343.14(2)(em) and s. 343.234 Wis. Stats.
WARNING Any applicant for a driver license who presents fraudulent
or altered documents or makes a false statement to the issuing ofcer or
agency, may be subject to a ne of not more than $1,000, imprisonment for
not more than six months or both. The driver license privilege may also be
revoked for one year. (s. 343.14(5) Wis. Stats.)
OPT OUT Under Wisconsin open records laws, WisDOT must provide
information from its records to requesters. If you do not want your name
and address included in requests we receive for ten or more records, you
may ask WisDOT to withhold your name and address from those lists by
checking the box on the application.
INSURANCE No person may operate a motor vehicle in Wisconsin unless
the owner or driver of the vehicle has liability insurance in effect for the vehicle
being operated and carries proof of insurance whenever driving. Failure to
have insurance could result in a ne up to $500. Refer to s. 344.61-344.65
Wis. Stats. for full details.
An unexpired Wisconsin
driver license is acceptable
photo ID for voting.
(
s. 5.02(6m) Wis. Stats.)
COMMERCIAL DRIVER LICENSE APPLICANT ONLY
If applying for a HAZMAT endorsement (HME), complete Driver License Hazardous Materials Endorsement Application, form MV3735.
If applying for a school bus endorsement, complete School Bus or Alternative Vehicle License Information Request, form MV3740.
6. Is the vehicle you will be operating equipped
with air brakes?
YES
NO
7. Do you meet all the driver qualications as required
by 49 CFR 391 to operate a commercial vehicle?
If not, see Motor Carrier Safety FAQs, publication
BDS218.
YES
NO
8. School Bus, CDL Instructional Permit and
New CDL Class/Endorsement Applicants Only.
Is the vehicle in which you will take the commercial
driver license skills test representative of the type
of vehicle you will operate or intend to operate?
YES
NO
9. School Bus Applicants Only.
Have you been convicted of an offense identied
on School Bus or Alternative Vehicle License
Information Request, form MV3740 in Wisconsin
or any other jurisdiction? If yes, list date and place:
YES
NO
1. In the past 5 years, have you had a loss of
consciousness or muscle control caused by a
neurological condition, for example, seizure disorder?
YES
NO
2. In the past 2 years, have you taken insulin
to control a diabetic condition?
YES
NO
3. In the past 2 years, have you taken oral
medication to control a diabetic condition?
YES
NO
4. Is your hearing impaired? (hard of hearing)
YES
NO
5. Have you held a valid operator's license in the
last 10 years from any jurisdiction (state) other
than Wisconsin?
If yes, list all states:
YES
NO
DRIVER LICENSE APPLICANT UNDER AGE 18 ONLY
Applicant Certication: I certify that in the past six months I have not
been ticketed for a moving violation that has or may result in a conviction.
I understand that falsifying this statement will result in the cancellation of
my probationary license. Applicant Signature – REQUIRED.
Sponsor Certication: As the adult sponsor under s. 343.15 Wis. Stats.,
I accept liability and verify that the minor is not a habitual truant and meets the
educational requirements for licensure. If required for this application, I certify
that the applicant has accumulated at least 30 hours of driving experience,
10 of which were at night.
X
Minor Name – Print
School Certication: I certify that this applicant is enrolled in approved
behind-the-wheel training which begins no later than 60 days from date signed.
Sponsor Name – Print Relationship to Applicant
School ID Number School Name Sponsor Wisconsin DL/ID Number Sex Birth Date
(mm/dd/yyyy)
X
Ofcial WisDOT Test Results (line out if not used)
(Sponsor Signature – Must be Witnessed by DMV Agent or Notarized)
Knowledge Test Highway Sign Test
State of Wisconsin County of Subscribed and sworn to before me on this date
Pass Fail Pass Fail
X X
(Authorized School Ofcial/Instructor Signature) (Date Signed)
(DMV Authorized Agent or Notary Signature) (My Commission Expires)
DO NOT Use Notary Seal
