Military Application to Accept an Out-of-State
Motorcycle Rider Education Program Certificate
Save time, go to mass.gov/RMV to apply online!
RMV/Driver Licensing Department ● 25 Newport Avenue Extension, Quincy, MA 02171
Fax: 857-368-0820
p.1 LIC105_0918
A. Applicant Information (please print legibly)
Last Name First Name Middle Name Suffix
Date of Birth (MM/DD/YYYY) License/Permit # Eye Color Daytime Phone #
Address
Street Apt. #
City State Zip Code
Mailing Address (If different)
Street
Apt. #
City State Zip Code
B. Military Base Information
Military Base Name Phone #
Address
Street
City State Zip Code
Course Completion Date (MM/DD/YYYY) Course Completion Card #
Training Course
Basic
Experience
Basic 3 Wheel
Experience 3 Wheel
You must prove lawful presence (this may be done online at mass.gov/rmv) and then mail completed application to the
address listed above within 180 days of the class graduation date, along with the following:
1. Copy of your Active Duty Military ID Card (Front and Back)
2. Copy of your Motorcycle Safety Foundation Completion Card
3. Copy of your Basic Rider Course Skill Evaluation Score Sheet and Knowledge Test
4. Check or Money Order for $45.00 payable to MassDOT, which will cover the motorcycle permit fee and the
endorsement fee (if applicable). If you already have an active Massachusetts motorcycle permit, you will only need to
pay $15 for the endorsement fee. If your application is not approved, the application fee(s) will be returned to you.
To get or renew any driver's license, ID card, or learner's permit, you need documentation showing U.S. citizenship or
lawful presence as required by federal and state law. This includes adding a motorcycle endorsement to your license.
Refer to the backside of this application for instructions.
Please note that copies of documents will not be returned.
If your application is approved, a new Massachusetts Driver’s License with your motorcycle endorsement will be mailed to
you within 10-15 days of receipt this application.
For RMV Use Only
Date Issued: ___________________________ Issued by: ________________________________________________
