Photo Identication Card Act 2008; Transport Planning
and Coordination Act 1994
Photo Identication Card
Page 1 of 2 TRB Forms Area Form F4772 CFD V01 Apr 2019
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Evidence of Identity (EOI) Requirements
You must give evidence of your identity. You may do so by
showing your Qld driver licence, industry authority, marine
licence indicator (conditions apply), APA or Photo ID card. All
cards must be current or expired by less than two years.
If you are unable to show one of the above you will need
to present three other acceptable EOI documents and
evidence of your Qld residential address. For a full list of
acceptable EOI, evidence of residential address and change
of name documents, please refer to the Evidence of Identity
Requirements for Individuals (form F4362) or visit
Please use this form to apply for:
the issue or replacement of a Photo Identication (Photo ID)
a replacement Adult Proof of Age (APA) card (now known as
Photo ID card).
To apply for a Photo ID card you must be at least 15 years of
age and reside in Queensland (Qld).
Important information about the delivery of your Photo ID
If your application is approved, your Photo ID card will be mailed
to your postal address within 14 days.
1. Personal details
Family name (please print)
Given name/s
Residential address
Postal address (if same as residential, write ‘as above’)
Daytime contact phone number
Date of birth
/ /
Town, state and country of birth
Email address
Do you want your residential address displayed on the
reverse of your Photo ID card?
Would you like to get e-notices and e-reminders?
Male (M) Female (F)
4. Is your name different to the name/s on your EOI
Yes You must show an EOI change of name
document. Please provide details of your
Category A (please print)
Evidence of Qld residential address (please print)
Category B (please print)
Category A or B (please print)
Document type
(for example Australian
Document number
(for example X0100011)
Document type
(for example telephone account)
Issue date
(for example 01/04/2019)
Document type
(for example Medicare card)
Expiry date
(if applicable)
Document type
Document number or expiry date
(do not give credit/debit card
3. Can you show your Qld driver licence, industry
authority, marine licence indicator, APA card or Photo
ID card?
2. Do you currently hold or have you ever been issued a
Qld driver licence, industry authority, marine licence,
APA card, Photo ID card or vehicle/vessel registration,
in any other name? (e.g. name at birth, maiden name,
previous married names, adoptive name, or other
Licence/authority/reference number
Provide details below
You must show three EOI documents, one
of which must show your signature, and one
evidence of residential address document.
Please provide details of your documents.
/ /
Previous family name/s
Previous given name/s
Note: an EOI document linking your previous name and
your current name may be required.
Print Form
Reset Form
Privacy Statement: The department collects this information under the Photo
Identication Card Act and the Transport Planning and Coordination Act so you
may apply for a Photo ID card. The department may disclose this information to
the Queensland Police Service (QPS) and interstate agencies that issue proof of
age or photo ID cards. Your digital photo may also be released to the QPS. The
department’s card contractor will have controlled access to your information,
digitised signature and digital photo to make your card. Information, including your
digital photo or digitised signature, may be disclosed to an authorised agency if
the information is connected to an application for its product. Your information will
not be disclosed to any other third party without your consent, unless authorised
or required by law.
7. Applicant’s declaration
I declare that I have read the answers I have given to the
questions in this application and that the answers are
complete, true and correct in every detail.
I understand that if I have stated anything that is false or
misleading, the Photo ID card granted to me as a result of
this application will be cancelled.
I understand that I may be prosecuted for giving or stating
any false or misleading information or documents.
I consent to the department taking, keeping and using my
personal information, documents, digital photo and digitised
signature for the purposes associated with my application.
I consent to the department verifying my EOI documents or
information provided by me with the issuing authority or their
Applicant’s signature
/ /
Authorising person’s declaration
I am satised the applicant’s signature matches the applicant’s
EOI documents which I have sighted.
Authorising person’s signature
/ /
Authorising person’s name
Ofce Stamp
It is an offence under the Photo Identication Card Act to
state anything or give a document to an authorised person
if you know it contains false or misleading information. The
maximum penalty may be more than $4700.
EOI sighted - address and details current on system
Applicant’s details conrmed in TICA/TRAILS
1:1 match performed
Application approved
Application not approved
Authorising person’s checklist (tick where applicable)
Question 4 continued...
your photo image is no longer a true likeness.
Note: You must return your card.
other reason
Please provide details.
your card is faulty.
Please give details about the fault.
Note: You must return your faulty card.
you have not received your card in the mail.
Please conrm your postal address details.
Change of name (please print)
Document type
(for example Qld BDM
issued Marriage
Document number
(for example
(for example
5. Have you been previously issued an APA or Photo ID
No Go to 7
Damaged Destroyed
Lost Stolen
6. Please indicate the reason you require a replacement
your card is:
Page 2 of 2 TRB Forms Area Form F4772 CFD V01 Apr 2019
Photo Identication Card Application/Replacement continued ... Page 2 of 2
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