Information about the Wisconsin

Driver License (DL) Application (form MV3001)

You will need to visit a DMV service center and present an MV3001 application when you:
apply for an original or duplicate* driver license or instruction permit
renew an existing driver license
apply for an occupational license
An application may only be submitted through the mail if you are unable to renew or obtain
a duplicate driver license because you are a Wisconsin resident who is temporarily out-of-state.
More information about:
renewing when out of state
fees
applying for a license
* Note: You may be eligible to order a duplicate driver license online rather than visit a DMV service
center. See our online duplicate driver license application for further information.

WISCONSIN DRIVER LICENSE (DL) APPLICATION

Wisconsin Department of Transportation

Clear Form

MV30012/2014Ch. 343 Wis. Stats.

An unexpired Wisconsin
driver license is acceptable
photo ID for voting.
(s. 5.02(6m) Wis. Stats.)

Acceptable proof of name and date of birth, legal presence, identity and Wisconsin residency are required.
APPLICATION COMPLETION REQUIREMENTS

ALL applicants, complete the top section on back.

If under age 18, also complete the UNDER AGE 18 section below.
CDL applicants, complete the CDL APPLICANT ONLY section below.

Your Federal Medical Certificate is required unless you drive a school
bus or drive for a political subdivision.
DONOR Check the box if you wish to help others by donating your organs,
tissue and eyes upon your death. Your gift will be used to save and improve
lives through transplantation, therapy, research or education. If you are at
least 18, checking the box indicates your legal consent for donation. You do
not have to answer this question to obtain a license.
ADA The Wisconsin Department of Transportation complies with the
Americans with Disabilities Act (ADA).
SOCIAL SECURITY NUMBER (SSN) If you have a SSN, you must
provide it (s. 343.14(2)(bm) Wis. Stats.). Your SSN may be used for
purposes authorized by law and to link your driver license and vehicle
registration records. Your SSN must correspond with the number issued by
the Social Security Administration. Federal regulation 49 CFR, Part 383.153
requires a SSN for commercial driver license privileges.

NOTICE TO MALES AGE 1825 By submitting this application, you

consent to be registered with the Selective Service System, if required
by Federal law. You also authorize the Department of Transportation to
forward any information contained in this application that is requested by
the Selective Service System for the purpose of registering you as provided
in s. 343.14(2)(em) and s. 343.234 Wis. Stats.
WARNING Any applicant for a driver license who presents fraudulent
or altered documents or makes a false statement to the issuing officer or
agency, may be subject to a fine of not more than $1,000, imprisonment for
not more than six months or both. The driver license privilege may also be
revoked for one year. (s. 343.14(5) Wis. Stats.)
OPT OUT Under Wisconsin open records laws, WisDOT must provide
information from its records to requesters. If you do not want your name
and address included in requests we receive for ten or more records, you
may ask WisDOT to withhold your name and address from those lists by
checking the box on the application.
INSURANCE No person may operate a motor vehicle in Wisconsin unless
the owner or driver of the vehicle has liability insurance in effect for the vehicle
being operated and carries proof of insurance whenever driving. Failure to
have insurance could result in a fine up to $500. Refer to s. 344.61-344.65
Wis. Stats. for full details.

COMMERCIAL DRIVER LICENSE APPLICANT ONLY

If applying for a HAZMAT endorsement (HME), complete Driver License Hazardous Materials Endorsement Application, form MV3735.
If applying for a school bus endorsement, complete School Bus or Alternative Vehicle License Information Request, form MV3740.
1. In the past 5 years, have you had a loss of
consciousness or muscle control caused by a
neurological condition, for example, seizure disorder?
2. In the past 2 years, have you taken insulin
to control a diabetic condition?
3. In the past 2 years, have you taken oral
medication to control a diabetic condition?
4. Is your hearing impaired? (hard of hearing)
5. H
 ave you held a valid operator's license in the
last 10 years from any jurisdiction (state) other
than Wisconsin?
If yes, list all states:

YES NO 6. Is the vehicle you will be operating equipped

with air brakes?

YES NO

7. Do you meet all the driver qualifications as required

by 49 CFR 391 to operate a commercial vehicle?
YES NO
If not, see Motor Carrier Safety FAQs, publication

BDS218.

YES NO

 chool Bus, CDL Instructional Permit and

YES NO 8. S
New CDL Class/Endorsement Applicants Only.

Is the vehicle in which you will take the commercial

driver license skills test representative of the type
YES NO
of vehicle you will operate or intend to operate?

YES NO

YES NO

9. School

Bus Applicants Only.
H
 ave you been convicted of an offense identified
on School Bus or Alternative Vehicle License
Information Request, form MV3740 in Wisconsin
or any other jurisdiction? If yes, list date and place:

YES NO

DRIVER LICENSE APPLICANT UNDER AGE 18 ONLY

Applicant Certification: I certify that in the past six months I have not
been ticketed for a moving violation that has or may result in a conviction.
I understand that falsifying this statement will result in the cancellation of
my probationary license. Applicant Signature REQUIRED.

Sponsor Certification: As the adult sponsor under s. 343.15 Wis. Stats.,

I accept liability and verify that the minor is not a habitual truant and meets the
educational requirements for licensure. If required for this application, I certify
that the applicant has accumulated at least 30 hours of driving experience,
10 of which were at night.
Minor Name Print

School Certification: I certify that this applicant is enrolled in approved

behind-the-wheel training which begins no later than 60 days from date signed.

Sponsor Name Print

Relationship to Applicant

School ID Number

Sponsor Wisconsin DL/ID Number

Sex

School Name

Official WisDOT Test Results (line out if not used)

Knowledge Test
Highway Sign Test
Pass Fail
Pass Fail

X
(Authorized School Official/Instructor Signature)

(Sponsor Signature Must be Witnessed by DMV Agent or Notarized)

State of Wisconsin County of

X
(Date Signed)

Birth Date (mm/dd/yyyy)

Subscribed and sworn to before me on this date

(DMV Authorized Agent or Notary Signature)

DO NOT Use Notary Seal

(My Commission Expires)

Page 2 of 2

WISCONSIN DRIVER LICENSE (DL) APPLICATION

Wisconsin Department of Transportation MV3001 2/2014 Ch. 343 Wis. Stats.

Clear Form

ALL APPLICANTS Please Print

Social Security Number

Applicant Name First, Middle, Last

Birth Date (mm/dd/yyyy)

Residence Address Street

Apt #

City

State

ZIP Code

County of Residence

Mailing Address ONLY IF DIFFERENT from Residence

Apt #

City

State

ZIP Code

County of Residence

Sex

Race

Eyes

Hair

Height

Weight

Former Name (if changed since last license or ID card)

Reason for Name Change

1. Do you wish to register to be an organ, tissue and eye donor? YES

Will you donate $2 to organ, tissue and eye donation efforts? YES
2. OPT OUT Do you wish to have your name and address
withheld from lists WisDOT sells?
3. Has your license, ID card or operating privilege ever been
revoked, suspended, cancelled, disqualified or denied?
If yes, list date and place:
4. Have you been convicted of operating while intoxicated
OUTSIDE of Wisconsin?
If yes, give date and place:
5. Do you hold a valid driver license/identification card
FROM ANOTHER STATE/COUNTRY?
If yes, list:
Years of licensed driving experience in the United States,
its territories and Canada. List:

Marriage Divorce Other List:

6. Do you need glasses or contact lenses

for driving?
7. In the past year have you had a loss of
consciousness or muscle control caused
YES NO
by any of the following conditions?

If yes, check condition(s) and list date(s):

YES

YES NO

YES NO

I certify that the information on this application is true under penalty

of perjury and I am a resident of Wisconsin. (s. 343.14(5) Wis. Stats.)

OFFICE USE ONLY

Date

Name/DOB Proof

Traumatic Brain
or Head Injury (2)

Muscle or
Nerve (2)

Seizure
Disorder (4)

Heart (6)

Stroke (2)

Mental (3)

Diabetes (5)

Lung (7)

8. Check ONLY ONE of the following three boxes.

I certify that I am a:
U.S. Citizen
Permanent or Conditional Permanent Resident
Temporary Visitor

State

Identity/SS Proof

Expiration Date
Residency Proof

 REGI CDLI CYCI SPRI JUVI MPDI

REAL ID

PROB RGLR OCCL SPRR JUVP NON

Application Type

ORG

RNW

DUP

REI

RSM

AMD COA

Class(es) Issued

Behind The Wheel School Name

School ID

Endorsements

Knowledge

Federal Medical Certificate Shown

H
Skill Test Score

NO

Reason for Reissue:

Product Type

Processor ID

Hearing (CDL Only) Driver Education

P C

Examiner ID

YES

(Date)

Wisconsin or Out-of-State License Number

Legal Presence

NO

9. I am a veteran registered with WDVA and wish to

YES
have my veteran status indicated on my driver license.

(DMV is required to verify your status with WDVA.)

X
(Applicant Signature)

YES

Highway Signs

YES

Expires:

NO

Payment

Amount

Check Cash CC Acct.

X
(Processor Signature)

(Processor ID)

VISION
Visual Acuity

Without RX

With RX

Right Eye

20/

20/

Left Eye

20/

20/

Check if vision section completed by DMV Examiner

Temporal Field of Recommended Restrictions or Comments, or Indicate (NONE):
Vision In Degrees

Being duly licensed to practice

Optometry Medicine, In Wisconsin, or Other

Corrective lenses required while driving

Color Perception
Normal Deficient

Progressive eye disease or cataracts

If Yes, to Progressive eye disease

I certify that the findings are correct
or cataracts one eye both eyes and I examined this applicant on:___________________________ (Exam Date)

YES NO
YES NO

Name of State or Country

Describe:

X
(Eye Examiner Signature)

(License #)

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