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Get VA DL 8 2012-2021

2-341. 12 G. Instructions Complete Self-Certification section and if eligible finalize form and attach any required documentation. To submit ON-LINE visit www. dmvNOW.com - under Important Notices click on New CDL Medical Certification Requirements. You will be required to scan this form and any applicable documents. DL 8 01/30/2012 COMMERCIAL DRIVER S LICENSE CDL SELF-CERTIFICATION LOG NUMBER Purpose Use this form to record and/or change a CDL driver s self-certification category for the driver s type of commercial motor vehicle operation as required by VA Code 46. DmvNOW.com - under Important Notices click on New CDL Medical Certification Requirements. You will be required to scan this form and any applicable documents. Or you may submit your information to DMV Driver Support by MAIL to the above address FAX to 804-367-6692 or by visiting any DMV customer service center. Required YOU CANNOT USE THIS FORM IF TO SUBMIT YOUR SELF-CERTIFICATION A - you checked NON-EXCEPTED Interstate/Intrastate Driver you have been granted a federal medical variance/waiver/Skill Performance Evaluation Certificate SPE and your current license does NOT display a V restriction or B - you checked EXCEPTED Interstate/Intrastate Driver and your current license displays a V restriction. You must go to a DMV customer service center to submit your self-certification with a completed form DL 1P Driver License and Identification Card Application and any necessary documentation. You will be issued a new license. If neither A nor B applies to you complete the Commercial Driver Information below sign and date the Certification and submit completed form with any necessary documentation according to the instructions shown at the top of this form. APPLICANT FULL LEGAL NAME print last first middle city ADDRESS street BIRTHDATE mm/dd/yyyy suffix CDL NUMBER state VA zip code DAYTIME TELEPHONE NUMBER EMAIL ADDRESS print clearly CERTIFICATION I certify and affirm that all information presented in this form is true and correct that any documents I have presented to DMV are genuine and that the information included in all supporting documentation is true and accurate. 2-341. 12 G. Instructions Complete Self-Certification section and if eligible finalize form and attach any required documentation* To submit ON-LINE visit www. Or you may submit your information to DMV Driver Support by MAIL to the above address FAX to 804-367-6692 or by visiting any DMV customer service center. DMV will process your information within 10 business days. INTERSTATE DRIVER NON-EXCEPTED - I meet the qualification requirements under 49 CFR Part 391 of the Federal Motor Carrier Safety Regulations. Medical examiner s certificate required Title 19 30-20-80 of the VA Administrative Code. EXCEPTED - I am exempt from the qualification requirements No medical examiner s certificate required under Title 19 30-20-80 of the VA Administrative Code. required YOU CANNOT USE THIS FORM IF TO SUBMIT YOUR SELF-CERTIFICATION A - you checked NON-EXCEPTED Interstate/Intrastate Driver you have been granted a federal medical variance/waiver/Skill Performance Evaluation Certificate SPE and your current license does NOT display a V restriction or B - you checked EXCEPTED Interstate/Intrastate Driver and your current license displays a V restriction* You must go to a DMV customer service center to submit your self-certification with a completed form DL 1P Driver License and Identification Card Application and any necessary documentation* You will be issued a new license. .

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