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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

Are you eligible for a Queensland (Qld) Driver Licence?
To be eligible for a driver licence in Qld you must:• prove your identity using original documents• be a resident of Qld• disclose medical conditions that may adversely affect your ability todrive safely.
You are not eligible to make this application if your licence issuspended or you are disqualified from driving in any Australian stateor territory or any other country.
The information you provide in this document must be true andcorrect otherwise the licence granted to you will be void and you may
be prosecuted for providing false or misleading information.
If your application/renewal is approved, your licence will be mailed toyou. This may take up to 2 weeks. You will receive a Driver Licence
Receipt today which will allow you to drive until you receive yourlicence.
Please PRINT clearly in dark pen (do not use pencil or erasable ink)

1. Personal details

3. Evidence of identity (EOI) and Qld residency

a. Can you show your Qld Driver Licence, Industry Authority,
Marine Licence (with photo) or Adult Proof of Age card that iscurrent or expired less than 2 years ago?
NoYes
Licence/reference number
Go to 4.
b. If you cannot show identification listed above, you must provide:
3 EOI documents + evidence of Qld residency. At least 1 EOI
document must show your signature.

(For a full list of acceptable EOI documents please see Evidence ofIdentity Requirements for Individuals (form F4362) or visit www.qld.gov.au)

All EOI documents must be ORIGINAL and include:
1 category A + 2 category B OR 2 category A + 1 category B.
Category A (e.g. passport, birth certificate, Australian photo driver licence)
Document Type

Document number (e.g. X0100011)(e.g. C0100011)

Category B (e.g. Medicare card)

Family name

Document Type

Given name/s

Expiry date (if applicable)

Category A or B
Document Type

Document number or expiry date

Date of birthdd/ mm /(do not give credit/debit card number)yy

Evidence of Qld residency address (e.g. bills for phone, electricity, rates)
Document Type

Gender: Male (M)Issue date

ddFemale (F)/ mm /yy

Town, state and country of birth

4. Is your name different from the name on your current
driver licence or EOI documents above?

Residential address

NoYes
You must show an EOI change of name document
Change of name document (e.g. Australian change of name certificate)
Document Type

Document number

Issue datedd
Postcode

Postal address (if same as residential address, write ‘as above’)Fill in details below. If you have a licenceissued by another Australian state or territory,
you must surrender it to be eligible for a Qlddriver licence.
Licence/reference number
Effective datePostcode

Daytime contact phone number

Yes

dddd

Do you currently hold or have you ever been issued a Qld driver
licence, industry authority, marine licence, adult proof of age cardor vehicle/vessel registration, in any other name? (e.g. name atbirth, maiden name, previous married names, adoptive name, orother aliases)
NoYes
Provide details below
Previous family name

Licence Type

V01 Dec 2016

Licence Class

LearnerCarP

Car (AutomaticCondition)
Learner Approved
MotorbikeOpenF3000

yy

What type/class of licence(s) are you renewing or applying for?

P2

Note: An evidence of identity document linking your previous
name and your current name may be required.

/ mm /

6. Licence type and class

P1

Previous given name/syy

Licence class/es (e.g. C/LR/MR)

Licence type (e.g. L/P/O)

2. Previous name or aliases/ mm /Expiry dateState/territory/country of issue

Email address

Page 1 of 2yy

5. Do you have a driver licence issued by another
Australian state or territory or country?
NoTRB_LC&A/ mm /Motorbike

C

Light Rigid

LRCAMedium Rigid

MR

Heavy Rigid

HR

Heavy Combination

HC

Multi-combination

MCRER

Are you applying for a licence or class of licence that you held
more than 5 years ago?
You must provide evidence of your previous licence
NoYes7. Medical Condition Reporting

You must report any medical condition/s that may adversely
affect your ability to drive.
a. Do you need to wear glasses/contact lenses for driving?
S condition will be shown on your licence
NoYes
b. Do you have any of the following conditions? Check each statement.
No YesVision or eye disorder (other than wearing glasses
or contact lenses) that may adversely affect yourdriving
Diabetes that requires treatment by tablet, insulin orother medication
Been diagnosed with epilepsy, experienced aseizure; or been required to take anti-epileptic
medication after the age of 11
Any other medical condition/s that is likely toadversely affect your ability to drive safely
If you have answered Yes to any statement at 7b, you must
provide a Medical Certificate for Motor Vehicle Driver (form F3712)
completed by your treating doctor.

8. Traffic history

a. Have you currently, or within the last 5 years, had your licence
cancelled or been disqualified from driving or obtaining a driver
licence by an Australian or overseas court?
Provide details below
NoYes
Reason for cancellation/disqualification

10. Applicant’s declaration

Sign only in the presence of an authorised person.
I declare that I have read the answers I have given to thequestions in this application and that the answers are complete,true and correct in every detail.
If undertaking a practical driving test, I declare that I have theconsent of the registered operator to use the vehicle for the test.
I also declare that the registered operator has given consent for
any Driving Examiner employed by the department or any PoliceOfficer, to drive the vehicle during or in connection with the test
undertaken in the vehicle, if required.
I understand that if I have stated anything that is false or
misleading, the driver licence granted to me as a result of thisapplication will be absolutely void and have no legal effectwhatsoever.
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 mypersonal information, documents, digital photo and digitised
signature for the purposes associated with my application.
I consent to the department verifying my EOI or evidence ofprevious licence provided by me with the issuing authority or theiragencies.
Additional declaration by interstate or overseas licence holders.
I understand that by signing this declaration I agree to thesurrender of my interstate driver licence.
I also consent to the department releasing information about
my application for a Qld licence to the issuing authority or theiragencies.
Applicant’s signature

Date
dd

State/territory/country

Durationb. Is your licence currently suspended for any reason including
speeding offences, demerit points, unpaid fines or any otherreason?
Provide details below
NoYes
Reason for suspension/ mm /yy

It is an offence under the Transport Operations (Road Use Management)
Act 1995 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.

Authorising person’s checklist
State/territory/country

EOI sighted - address and details current on system

Duration

S or M conditions checked/added/amended
M condition reported - F3712 attached if required
Court orders/restrictions - sighted and copies attached, codes added

9. Court Orders - restricted licence

Have you been granted a current court order for any of thefollowing? Check each statement.

O/S - licence/documents sighted, copied and attached if required

No Yes CodeA drink or drug driving conviction

X1

Special Hardship Order (SHO)

X3

An order allowing you to drive until your drink ordrug driving charge is heard in court

X4

If you have answered Yes to any of the above, you will need toshow your court order/s. The relevant code will be shown on yourlicence. You must comply with the court order and carry it with you
when driving.
Privacy statement: The Department of Transport and Main Roads (thedepartment) collects this information under the provisions of the TransportOperations (Road Use Management) Act and Transport Planning andCoordination Act so that 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 bereleased to the QPS. The department’s card production contractor will havecontrolled access to your information, digitised signature and digital photo tomake your card. Information, including your digital photo or digitised signature,
may be disclosed to an authorised agency if the information is connected toan application for its product. Your information will not be disclosed to any
other third party without your consent, unless required or authorised by law.
TRB_LC&A

Page 2 of 2

F3000

V01 Dec 2016

O/S - translations of O/S document copied and attached if required
Application Approved / Refused
Comments by authorising person

Authorising person’s declaration
I have witnessed the applicant’s signature and checked that itmatches the applicant’s evidence of identity which I have sighted.
Authorising person’s nameSignature
Office stamp / date