Drivers License application Form

Drivers License Application Form

REPUBLIC OF LIBERIA

MINISTRY OF TRANSPORT

CORNER OR WARREN & CAREY STREETS

MONROVIA

Driver License Form

NON-NATIONAL DL DATA COLLECTION FORM:

SUR NAME

FIRST NAME

MIDDLE NAME

DATE OF BIRTH

MONTH

DATE

YEAR

PLACE OF BIRTH

CITY

DISTRICT/PROVINCE

COUNTRY

COUNTRY OF ORIGIN:

NATURALIZED#:

SEX: MALE ( ); FEMALE ( ) NATIONALITY

DATE OF ENTRY

RESIDENCE PERMIT #:

FIRST PERMIT SSUANCE DATE :

PERMIT RENEWAL DATE :

HEIGHT

WEIGHT

PHONE #:

CURRENT ADDRESS:

CITY

DISTRICT #:

COUNTY #:

COUNTRY #:

EYE SIGHT

EYE COLOR

BLOOD GROUP

THE UNDERSIGNED DO HEREBY CONFIRM THAT THE INFORMATION PROVIDED BY ME IS TRUE ALL ACCURATE TO THE BEST OF MY KNOWLEDGE AND THAT ANY INFORMATION FOUND TO BE MISLEADING MY APPLICATION FOR DRIVER'S LICENSE WILL BE DENIED .

FIRST TIME APPLICANT REQUESTED TO PRESENT COPY OF LNP CLEARANCE.

Date

DIVISION OF MOTOR VEHICLE - MoL

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