Driver Licence Application/Renewal

(Learner, P1, P2, P type and Open Licence)

Transport Operations (Road Use Management) Act 1995;

Transport Planning and Coordination Act 1994
Please use this form if you are applying for the grant or renewal of
a Queensland (Qld) driver licence. You are not eligible to make this
application if your licence is suspended or cancelled or you are
disqualified from holding or obtaining a driver licence in any Australian
state or territory, or any other country.

Category A (please print)

Document type

1. Personal details
Family name (please print)

Change of name (please print)

Document type
Document number

(for example Qld BDM birth certificate)

Document number

(for example X0100011)

Category B (please print)

Evidence of Identity (EOI) Requirements
Document type
Document number (do not
You must give evidence of your identity. You may do so by showing
(for example credit card)
give credit/debit card number)
your Qld driver licence, industry authority, marine licence indicator
(conditions apply) or adult proof of age (APA) card. All cards must
be current or expired by less than two years.
Category A or B (please print)
If you are unable to show one of the above you will need to present
Document type
Document number
three other acceptable EOI documents and evidence of your Qld
residential address. For a full list of acceptable EOI, evidence of
residential address and change of name documents please refer
Evidence of Qld residency address (please print)
to the Evidence of Identity Requirements for Individuals (form
Document type
Issue date
F4362) or visit www.qld.gov.au.
(for example telephone account)
(for example 10/06/2010)
Medical Condition Reporting
You must tell the Department of Transport and Main Roads of any
medical condition that may adversely affect your ability to drive
4. Is your name different to the name/s on your EOI documents?
safely. You may need a medical certificate confirming your fitness
Go to 5
No
to drive. Your health professional may also recommend that your
licence be subject to conditions. Please visit www.qld.gov.au for
You must show a change of name document. Please provide
Yes
further information.
details of your document.

(for example, Qld BDM issued

Marriage Certificate)

Given name/s

Male
Female

Residential address

(for example, 001000)

Registration year

(for example, 2010)

5. Do you have a driver licence issued to you by another

Australian state or territory, or country?
No

Go to 6

Yes

Driver licence number (if known) Effective date

Day

Postcode
Postal address (if same as residential, write as above)

Expiry date
Day

Month

/
/
Licence type

Postcode

Year

Month

Year

/
/
State/Territory/Country of issue
Licence class/es

Email address
Daytime contact phone number

Note:If you have a driver licence issued by another Australian state

or territory, you are not eligible for a Qld driver licence if you do
not surrender your interstate licence.

Date of birth
Day

Month

Year

Licence type

Town and country of birth

Eye colour

Height

Hair colour

Complexion

cms
2. Have you ever held a Qld driver licence in another name?
No

Go to 3

Yes

Family name (please print) Given name/s

Driver licence number (if known) Expiry date
Day

Month

Year

3. Can you show your Qld driver licence, industry authority,

marine licence indicator or APA card?
Yes

Licence/authority/reference number

Go to 4
No

6. What type and class/es of licence are you applying for?

You must show three EOI documents, one of which must show
your signature, and one evidence of residential address
document. Please provide details of your documents.

Licence class/es

Learner

Car

P
P1

Car (Automatic
Condition)
Learner Approved
Motorcycle

P2

Motorcycle

Open

*Specially
Constructed
Vehicle

UD

Light Rigid

LR

CA

Medium Rigid

MR

RE

Heavy Rigid

HR

Heavy
Combination
Multicombination

HC
MC

*Note:Class UD is not issued to new applicants; specially constructed

vehicles (excluding mobile cranes of more than 4.5t) may be
driven under the authority of a class C licence.
You must provide evidence of your previous licence if you are applying
for a licence you have not held for more than five years.

7. Do you currently have a Qld marine licence?

No
Go to 8
Yes

What marine licence do you hold?

Recreational marine driver licence

RMDL

Personal watercraft licence

PWCL

Continued over page...

Page 1 of 2 TRB Forms Area F3000 CFD V01 Nov 2015

8. Are you currently or have you recently been disqualified #Note 2: A Medical Certificate is required if your licence has an M condition
and your doctor has indicated you meet the criteria for an
from holding or obtaining a marine licence by an order of
unconditional licence.
an Australian or overseas court?
18. Applicants declaration
No
Go to 9
Yes

State/Territory/Country

Length of disqualification

9. Are you currently or have you recently been disqualified

from holding or obtaining a driver licence by an order of
an Australian or overseas court?
No
Go to 10
Yes

State/Territory/Country

Length of disqualification

10. Have you been granted a court order for any of the
following reasons? (Please show your court order)
(a) Restricted licence order for a drink or drug driving conviction
No

Yes

Code X1 will be shown on your driver licence.

Sign only in the presence of a departmental person.

I declare that I have read the answers I have given to the questions in
this application and that the answers are complete, true and correct in
every detail. I understand that if I have stated anything that is false or
misleading, the driver licence granted to me as a result of this application
will be absolutely void and have no legal effect whatsoever. I understand
that I may be prosecuted for giving or stating any false or misleading
information or documents. I consent to the department taking, keeping
and using my personal information, documents, digital photo and
digitised signature for the purposes associated with my application.
I consent to the department verifying my EOI or evidence of previous
licence provided by me with the issuing authority or their agencies.
Additional declaration by interstate licence holders
I understand that by signing this declaration I agree to the surrender
of my interstate driver licence.
Applicants signature

Date

Day

(b) Special Hardship Order (SHO)

No

Yes

Code X3 will be shown on your driver licence.

(c) s79E order for a drink or drug driving related offence

No

Yes

Code X4 will be shown on your driver licence.

11. Has your licence been cancelled for any other reason?
No

Go to 12

Yes

Reason for cancellation

State/Territory/Country

Period

12. Is your driver licence currently suspended for any of the

following reasons?
Speeding offence
No
Yes
Give
No
Yes
Accumulation of demerit points
details
Unpaid fines
No
Yes
below
Any other reasons
No
Yes
Period
State/Territory/Country

Month

Year

It is an offence under the Transport Operations (Road Use Management)

Act to state anything or give a document to an authorised person if you
know it contains false or misleading information. The maximum penalty
may be more than $7000.

19. Registered operators authorisation for test vehicle

I authorise any Driving Examiner employed by the department or any

Police Officer, to drive my vehicle during or in connection with any
driving test undertaken in my vehicle, if required.
Vehicle registration number
Registered operators signature

Date

Day

Month

Year

Privacy Statement: The department collects this information under the provisions
of the Transport Operations (Road Use Management) Act and Transport Planning
and Coordination Act so you may apply for a Qld driver licence. The department may
disclose this information to interstate and foreign driver licensing authorities, and the
Queensland Police Service (QPS). Your digital photo may also be released to
interstate driver licensing authorities and the QPS. The departments card production
contractor will have controlled access to your information, digitised signature and
digital photo to make your card. Information, including your digital photo or digitised
signature, may be disclosed to an authorised agency if the information is connected
to an application for its product. Your information will not be disclosed to any other
third party without your consent, unless required or authorised by law.

Office Use Only

13. Do you need to wear glasses/contact lenses for driving?
No

Yes

S condition will be shown on your licence

14. Do you have any other vision or eye disorder?

No

Yes

Practical driving test results

Class tested
Code/condition (if any)
Passed
Examiners signature

Date

Day

Medical certificate (form F3712) is required

Note: Your doctor may require a report from an Optometrist or

Ophthalmologist.

Failed

Examiners number

Month

Year

Report number

15. Do you have diabetes?

No

Yes

How is your diabetes controlled?

Medical certificate (form F3712) is

not required

Diet only
Insulin or other
glucose-lowering
agent

Medical certificate (form F3712) is

required (see Note 1*)

Tick where applicable

Applicants details confirmed
in TRAILS/TICA
1:1 match performed

Applicants EOI confirmed

Application approved

Returning driver-previous licence verified and recorded (if required)

Application not approved

16. Have you been diagnosed with epilepsy or experienced a
seizure at any time?
Comments
No
Go to 17

Yes

Have you experienced a seizure or been required to

take anti-epileptic medication after the age of 11?
No

Yes

Medical certificate (form F3712) is

required (see Note 1*)

17. Do you have any other medical condition that is likely to

adversely affect your ability to drive safely?
No

(See Note 2#) Yes

Medical certificate (form F3712) is

required (see Note 1*)

Give refusal letter

Authorising persons declaration

I declare that I witnessed the applicants signature. I am satisfied the

signature accords satisfactorily with the signature appearing on the EOI
document/s, if applicable. I also declare that I sighted the EOI, evidence of
Qld residency, change of name documents and evidence of previous licence
as required.
Authorising persons name

*Note 1: You and your doctor must also complete the Private and Commercial Authorising persons signature
Vehicle Drivers Health Assessment (form F3195) if you hold or
are applying for a licence to drive:
a vehicle that is more than 8t GVM (class MR, HR, HC, MC)
a public passenger vehicle (e.g. taxi, limousine, bus)
Office Stamp
a vehicle carrying dangerous goods.

Date

Day

Month

Year

Page 2 of 2 TRB Forms Area F3000 CFD V01 Nov 2015