Fillable TEXAS COMMERCIAL DRIVER LICENSE APPLICATION INTERSTATE DRIVER CERTIFICATION (Texas Real Estate Contracts)

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TEXAS COMMERCIAL DRIVER LICENSE APPLICATION INTERSTATE DRIVER CERTIFICATION (Texas Real Estate Contracts)

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The TEXAS COMMERCIAL DRIVER LICENSE APPLICATION INTERSTATE DRIVER CERTIFICATION (Texas Real Estate Contracts) form is 2 pages long and contains:

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File type: PDF

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The Texas Real Estate Commission (TREC) is an agency that governs real estate practices in the state of Texas USA. I its headquarters are located in Ausin Texas at 1700 North Congress.

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WHAT IS INTERSTATE COMMERCE?
Trade,trafc,ortransportationintheUnitedStateswhichisbetweenaplaceinastateandaplaceoutsideofsuchstate
(includingaplaceoutsideoftheUnitedStates);or
BetweentwoplacesinastatethroughanotherstateoraplaceoutsideoftheUnitedStates;or
Betweentwoplacesinastateaspartoftrade,trafcortransportation,originatingorterminatingoutsidethestateorthe
UnitedStates.
Reminder: Youmaybeengagedininterstatecommerceevenifyourvehicledoesnotleavethestate.
INSTRUCTIONS
Inordertoobtainacommercialdriverlicensewhichauthorizestheoperationofacommercialmotorvehicleininterstateorforeigncom-
merce,youmustcertifytoandmeetthequalicationsfromFederalRule49C.F.R.,Part391.Pleasereviewthefollowingrequirements.
Ifyoumeettheserequirements,certifybelow.
CERTIFICATION
IcertifythatI:
a. amatleast21yearsofage;
b. canreadandspeaktheEnglishlanguagesufcientlytoconversewiththegeneralpublic,tounderstandhighwaytrafcsigns
andsignalsintheEnglishlanguage,torespondtoofcialinquiries,andtomakeentriesonreportsandrecords;
 c. amnotdisqualiedtodriveamotorvehicleinanystate.
SECTION A. I FURTHER CERTIFY THAT I: (Check the appropriate box(es) below)
1. Donothavealossofafoot,aleg,ahand,oranarm,orhavebeengrantedawaiver;
2.
Donothaveanimpairmentof:
i. Ahandorngerwhichinterfereswithprehensionorpowergrasping;or
ii. Anarm,foot,orlegwhichinterfereswiththeabilitytoperformnormaltasksassociatedwithoperatingamotor
vehicle;oranyothersignicantlimbdefectorlimitationwhichinterfereswiththeabilitytoperformnormaltasks
associatedwithoperatingamotorvehicle;
3.
Donothaveacurrentclinicaldiagnosisofmyocardialinfarction,anginapectoris,coronaryinsufciency,thrombosis,or
anyothercardiovasculardiseaseofavarietyknowntobeaccompaniedbysyncope,dyspnea,collapse,orcongestive
cardiacfailure;
4. Donothaveanestablishedmedicalhistoryorclinicaldiagnosisofarespiratorydysfunctionlikelytointerferewithmyabilityto
controlanddriveamotorvehiclesafely;
5.
Donothaveacurrentclinicaldiagnosisofhighbloodpressurelikelytointerferewithmyabilitytooperateamotorvehicle
safely;
6.
Donothaveanestablishedmedicalhistoryorclinicaldiagnosisofrheumatic,arthritic,orthopedic,muscular,neuromuscular,or
vasculardiseasewhichinterfereswithmyabilitytocontrolandoperateamotorvehiclesafely;
CDL-4 (Rev. 12/18) (OVER)
TEXAS COMMERCIAL DRIVER LICENSE APPLICATION
INTERSTATE DRIVER CERTIFICATION
NOTICE:AllinformationonthisapplicationmustbeinINK.
APPLICANT INFORMATION
LASTNAME FIRSTNAME
DATEOFBIRTH(mm/dd/yyyy) DRIVERLICENSENUMBER
SOCIALSECURITYNUMBER
7. Donothaveanestablishedmedicalhistoryorclinicaldiagnosisofepilepsyoranyotherconditionwhichislikelytocauseloss
ofconsciousnessoranylossofabilitytocontrolamotorvehicle;
8.
Donothaveamental,nervous,organic,orfunctionaldiseaseorpsychiatricdisorderlikelytointerferewithmyabilitytodrivea
motorvehiclesafely;
9.
Havedistantvisualacuityofatleast20/40(Snellen)ineacheyewithoutcorrectivelensesorvisualacuityseparatelycorrected
to20/40(Snellen)orbetterwithcorrectivelenses,distantbinocularacuityofatleast20/40(Snellen)inboth
eyeswithorwithoutcorrectivelenses,eldofvisionofatleast70ºinthehorizontalMeridianineacheye,andtheability
torecognizethecolorsoftrafcsignalsanddevicesshowingstandardred,green,andamber;
10.
Firstperceiveaforcedwhisperedvoiceinthebetterearatnotlessthan5feetwithorwithouttheuseofahearingaidor,
iftestedbyuseofanaudiometricdevice,donothaveanaveragehearinglossinthebettereargreaterthan40decibelsat500
Hz,1,000Hz,and2,000HzwithorwithoutahearingaidwhentheaudiometricdeviceiscalibratedtoAmericanNational
Standard(formerlyASAStandard)Z24.5-1951;
11.
DonotuseaScheduleIdrugorothersubstance,anamphetamine,anarcotic,oranyotherhabitformingdrug;and
12.
Donotuseanynon-ScheduleIdrugorsubstancethatisidentiedintheotherSchedulesin21part1308exceptwhentheuse
isprescribedbyalicensedmedicalpractitioner,asdenedin§382.107,whoisfamiliarwiththedriver’smedicalhistoryand
hasadvisedthedriverthatthesubstancewillnotadverselyaffectthedriver’sabilitytosafelyoperateacommercialmotor
vehicle;
13.
Donothaveacurrentclinicaldiagnosisofalcoholism.
IF YOU CHECKED ALL THE BOXES ABOVE, SKIP SECTION B
SECTION B. I FURTHER CERTIFY THAT I: (Check the appropriate box below)
YES NO
HaveafederalvarianceforoneofthemedicalconditionsthatIhaveselectedbelow(selectallthatapply).
Afederalvariancemustbesubmittedwithacurrentmedicalexaminer’scerticatewhencertifyingtothissection.
Vision Limb Seizures Hearing
I CERTIFY THAT I HAVE READ, UNDERSTAND AND MEET THE PRECEDING QUALIFICATIONS, AND THAT I OPERATE
OR EXPECT TO OPERATE IN INTERSTATE COMMERCE, AND I AM BOTH SUBJECT TO AND MEET THE QUALIFICATION
REQUIREMENTS UNDER 49 C.F.R. PART 391. I MEET THE REQUIREMENTS OF CATEGORY 1, NON-EXCEPTED INTERSTATE.
I ALSO UNDERSTAND BASED UPON THIS CERTIFICATION THAT I AM REQUIRED TO OBTAIN AND PRESENT TO THE
DEPARTMENT A VALID MEDICAL EXAMINER’S CERTIFICATE UNDER 49 C.F.R. PART 391.45.
APPLICANT’SSIGNATURE DATE
Sworntoandsubscribedbeforemeonthisthe dayof ,
NotaryPublicorAuthorizedOfcer
FOR DEPARTMENT USE ONLY
Thisformmayrequireoneofthefollowingrestrictionstobeplacedonthecommercialdriverlicense.
P15–OperationClassAexemptvehicleauthorized
V –Medicalvariancedocumentationrequired
Class A – TexasCommercialRules,GeneralKnowledge,Combination,Air-brake(ifapplicable),Pre-trip,andanynecessary
endorsementexams.
Class B – TexasCommercialRules,GeneralKnowledge,Air-brake(ifapplicable),Pre-trip,andanynecessaryendorsementexams.
Class C – GeneralKnowledgeandanynecessaryendorsementexams.
Skills exams required: Yes
AMedicalExaminer’sCerticateisrequired.
Non-exceptedInterstate
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TEXAS COMMERCIAL DRIVER LICENSE APPLICATION INTERSTATE DRIVER CERTIFICATION (Texas Real Estate Contracts)

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Completed 27 October 2020

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