Application for a Driving Licence DL1

Surname

First Name

Middle name(s)

Address line 1

Address line 2

address

Provisional

Add category

Renew

Duplicate

Exchange non IOM driving licence*

Telephone

number

Address line 3

D.O.B and

Place of Birth

UK & NI Rep. of Ireland Guernsey Jersey

Other (please specify)

Update my photograph

Change my name or address

Post Code

IOM

Other (please specify)

MsMissMrsMr

Section 1 - Your details

What is the number of your Isle of Man driving licence?

(if you know what it is)

Title

Section 2 - What licence are you applying for?

(select all options that apply with a cross)

Section 3 - Your health

Please confirm if you have been advised by a Doctor or Consultant that you have a

disability or medical condition that may affect your fitness to drive. You must tick

YES even if you have previously declared it.

It is important that you read the accompanying leaflet Applying for a driving licence before

completing this form. Please use upper case letters and black ink. (select options with a x )

Application for a Driving Licence

DL1

*There are different requirements depending on the issuing authority of your driving licence.

For UK licence exchange please see page 4 of the Guide to applying for a Driving Licence. – if unsure please phone 01624 686827

Yes

Do you wear glasses, contact lenses or other corrective lenses for driving?

Yes No

Are you able, with or without the aid of corrective lenses in good daylight, to read a

number plate with character sizes 79 x 57 mm from a distance of 20.5m; or from

12.3m in the case of a licence application for a pedestrian controlled vehicle or

mowing machine?

Yes* No

*If you select Yes, then you must complete and include a Supplementary Medical Information form MI1 with your application.

Forms can be downloaded from www.Gov.im or collected from the Vehicle Test Centre, Tromode, Douglas, Isle of Man

Upgrade from provisional to full

General advice relating to the completion of this application form can be obtained by calling 01624 698525

For exchange licences please state in which

country you passed your driving test.

International Driving Permit

Remove Endorsement

DVLA Check Code (only applicable

for UK Exchanges)

Method of

payment

Adoption certificate

Current passport

Current proof of age card Marriage certificateBirth certificate

Deed poll or statutory declarationCivil partnership certificate

MI1 form

Decree nisi or absolute

Section 5 - To be completed by the person endorsing your photograph

The photograph that I have endorsed with “I certify that

this is a true likeness of (insert name of applicant) and

signed is a person whom I have known for at least 2

years and I agree to any checks being made in relation to

this application.

Full name

Address

Telephone Number

Profession /

Occupation

Signature

Date

Section 6 - Checklist

The required fee and supporting documentation depends on your application: please refer to the driving licence application guide and price

guide for more information.

(select all that apply with a cross)

Section 8 – Your statement

By signing this application form I confirm that:

· the information I have given in this application is, to the

best of my knowledge, true and correct.

· I reside in the Isle of Man.

· I am not disqualified from driving by order of any court.

PLEASE FIX PHOTO HERE

Signature

(please keep your signature within

the box)

Section 4 - Organ donation

As of 1

February 2022 we no longer retain Organ Donation information.

If you wish to register your details you can directly at: www.organdonation.nhs.uk or Telephone: 0300 123 2323

Date

It is a criminal offence to:

· Make a false statements in connection with licences under

the Road Traffic Act 1985. The penalty for contravention is

up to 3 months imprisonment or a fine of up to £2,500 or

both.

Road Traffic Act 1985 49 (1)

· obtain a driving licence whilst disqualified from driving. The

penalty for contravention is a fine of up to £2,500.

Road

Traffic Act 1985 Sch 3 18 (a)

· fail to notify the onset of a disability. The penalty for

contravention is a fine of up to £1,000.

Road Traffic Act 1985

Sch 3 5A(3)

Your application will not be accepted unless

it is signed and dated.

Fee

Cash (do not send by post) Cheque or Postal Order* Credit/debit card

*If you are submitting your application to a Post Office, please make payable to IOM Post Office; if submitting to the licensing centre, please

make payable to IOM Government

OFFICE USE ONLY

I.D. ____________________________________

Fee: £___ - ___Medical

Issuing Officer & Signature:

___________________________________________

Type:__________________________________

Section 7 - Payment

Your photograph Current driving licence MiCard

NHS card

Our Privacy Notice explains how we collect, store and handle your personal data in line with current data

protection legislation as applied in the Isle of Man. If you would like to find out more please visit our

website at

https://www.gov.im/about-the-government/departments/infrastructure/data-protection/

or contact our Data Protection Officer on 686785 for a paper copy