STATE OF TENNESSEEDepartment of Safety and Homeland Security Commercial Driver License Section CDL Holder SelfCertification Affidavit In order to comply with 49 CFR 383.71 and 49 CFR 383.73, the Tennessee.

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How to fill out the CDL Holder Self Certification Affidavit online

The CDL Holder Self Certification Affidavit is an essential document for commercial driver license holders in Tennessee. This guide will provide you with clear and detailed instructions on how to complete the affidavit online, ensuring compliance with federal and state regulations.

Follow the steps to accurately complete your affidavit.

  1. Click ‘Get Form’ button to obtain the CDL Holder Self Certification Affidavit and open it for editing.
  2. Begin by entering your personal information in the designated fields, including your full name and CDL number.
  3. Select the appropriate certification option by initialing one of the four statements regarding your driving operations, ensuring it accurately reflects your situation.
  4. Affirm the accuracy of the information provided by signing in the signature section and including the date of signing.
  5. Gather a copy of your medical examiner’s certificate, as you will need to submit it alongside the affidavit.
  6. Once you have completed the form and attached the necessary documents, you can save your changes, download the completed affidavit, print it out, or share it as needed.

Complete your CDL Holder Self Certification Affidavit online today to ensure compliance and maintain your driving privileges.

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What happens if your medical card expires in Texas?

An expired medical card means you are unqualified to drive a commercial vehicle. I do believe you have a one year grace period to get it done and not have to retake the tests. If you get your physical in the morning do the self certification and send it to DMV and nothing else will be needed on your part.

Go to the National Registry website: https://nationalregistry.fmcsa.dot.gov. Logon to your National Registry account. Select CMV Driver Exams from the blue bar at the top of the screen. Select Submit CMV Driver Exam Results

Commercial Driver License Self-Certification, form TC 94-169. Download the form here from Kentucky Transportation Cabinet Division of Driver Licensing. Copy of your valid DOT medical card (Medical card only, not the long form). Provide a legible copy of both front and back of the medical card.

Mail the completed form to the Division of Driver Licensing, CDL Section, 200 Mero St., Frankfort, KY 40622, or submit the form electronically via My CDL Document Portal at: http://mycdl.ky.gov.

If you select either the EA or EI box, you will be able to keep your CDL without submitting a current medical card. If/When you return to driving a commercial vehicle and you need to carry a medical card, you must resubmit a DL-11CD, Self-Certification Form, along with a copy of your valid medical card.

Excepted Intrastate (EA), you operate or expect to operate in a city, county state or federal vehicle ONLY and are exempt from the FMCSA driver qualification requirements. Federal Motor Carrier Safety Regulations require self-certification.

CDL Holder Self-Certification Affidavit §383.73, the Tennessee Department of Safety and Homeland Security requires all commercial driver license holders to certify the type of driving they engage in and provide a copy of their medical examiner's certificate (form 5876) to the Department.

This category will NOT require a medical examiners certificate, but you are still required to meet Texas medical standards. This certification category is when you are operating a CMV only in intrastate commerce for excepted activities (oil/water well servicing and/or drilling or mobile crane operations).

You will need to provide the CDL Section with a copy of your TWIC card. Upon verification of the card, it will be added to your Kentucky driving record. The email address for submission of a copy (front and back) of the TWIC document is kytc.twic@ky.gov and the fax number is 844-535-7272.

Any driver with an updated certificate can submit it to DPS via email at CDLMedCert@dps.texas.gov or by fax at (512) 424-2002.

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