478 Form Alaska PDF Details

The 478 Alaska form serves as a comprehensive application for individuals seeking to obtain a driver's license, permit, or identification card within the state. This critical document, administered by the State of Alaska Division of Motor Vehicles, encompasses various aspects necessary for the application process. Applicants have the opportunity to select from different types of licenses or permits, including classifications for commercial and non-commercial drivers, alongside specific endorsements like hazardous materials or motorcycle operation. It mandates the provision of full legal names, contact details, and distinguishing physical characteristics to ensure accurate identification. Furthermore, the form extends into more personalized territories, seeking information about veteran status—a gesture towards honoring military service by offering potential benefits and designations on the issued document. Additionally, it poses questions regarding organ donor preferences, promoting awareness and support for anatomical gifts. Voter registration is also integrated into the form, simplifying the process for U.S. citizens in Alaska to stay engaged with civic duties, provided they meet the eligibility criteria. Another crucial feature includes sections pertaining to medical conditions or impairments that might affect driving abilities, aiming to safeguard public road safety. Moreover, individuals with previous names or out-of-state permits and licenses are required to disclose such information, ensuring a transparent and thorough review process. Acknowledgment of domicile in Alaska for commercial drivers signifies the form's depth in catering to diverse applicant needs. By signing the form, applicants affirm the accuracy of provided information under penalty of perjury, illustrating the serious legal undertaking involved in applying for driving privileges or identification in Alaska.

QuestionAnswer
Form Name478 Form Alaska
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesalaska real id application form, alaska dmv vision form, alaska dmv form 478, application alaska dmv form

Form Preview Example

STATE OF ALASKA

DIVISION OF MOTOR VEHICLES

APPLICATION FOR ALASKA DRIVER LICENSE,

PERMIT OR IDENTIFICATION CARD

478

LICENSE / PERMIT

 

 

CLASSIFICATION

 

 

 

ENDORSEMENTS

 

 

 

 

 

 

 

 

 

Driver License

 

Non-Commercial (D)

 

 

Hazardous

 

Passenger (P)

Instruction Permit

 

Motorcycle

 

 

Tank (N)

 

School Bus (S)

Identification Card

 

CDL

A B C

 

 

Tank (N) + HazMat (H)

 

Doubles / Triples

FULL

 

First

 

 

Middle

 

 

 

Last

 

 

Suffix

LEGAL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AK license / permit / ID number, if applicable.

 

Date of Birth

 

Sex

 

 

Height

 

Weight

 

Hair Color

Eye Color

 

 

 

 

 

 

 

 

 

 

ft

in

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PLACE

 

City

 

 

 

State

 

Country (If other than USA)

 

Social Security Number

OF

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BIRTH:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mailing Address (This address will appear on the license, permit or ID.)

City

State

Zip Code

Residence Address (Physical location – no PO Box or Mail Receiving Station addresses.)

City

State

Zip Code

Email

Phone #

 

I declare myself an honorably discharged US Armed Forces veteran and authorize DMV to send my personal information to the

YES

NO

VETERAN

Dept. of Military and Veterans Affairs to provide benefits to me.

 

 

 

I have a US Armed Forces honorable discharge and wish to have a veteran designation placed / retained on my license.

YES

NO

ORGAN DONOR

Would you like to be an organ donor with a designator displayed on your license / ID card?

YES

NO

Would you like to donate $1 or more to the anatomical gift awareness fund? If so, how much?

$

 

 

 

VOTER

REGISTRATION

Would you like to register to vote or make changes to your voter registration

YES

NO

 

 

Are you a U.S. Citizen? You may not register to vote if you are not a U.S. citizen.

YES

NO

 

 

Have been convicted of a felony?

YES

NO

 

 

Have you been unconditionally discharged?

YES

NO

 

 

Would you like your residence address kept confidential? (Your residence address must be DIFFERENT than your mailing

YES

NO

address to be kept confidential.)

 

 

If you are already registered to vote in the State of Alaska, this form will update your voter registration address.

 

 

Do you want your address updated for voter registration purposes?

YES

NO

(In order to be a registered voter of Alaska, you must provide an Alaska residence address.)

 

 

 

 

 

PREVIOUS

List any previous / maiden names by which you have been known:

 

 

NAMES

 

 

 

 

 

 

 

 

List any States in which you have ever held a permit, license or id card:

 

 

 

Have your driving privileges ever been suspended or revoked or application for license refused?

YES

NO

DRIVER

State:

Date:

Reason:

 

 

LICENSE

 

 

State:

Date:

Reason:

 

 

QUESTIONS

 

 

Within the past 5 years, have you had a medical condition or impairment, mental or physical disorder, seizure, or any other

YES

NO

(You do not need to

health problems that could affect your ability to safely operate a motor vehicle?

answer these

 

 

 

 

 

 

 

questions for an ID

If yes, please explain:

 

 

 

 

card)

 

 

 

 

Within the last five years, have you had three or more alcohol or drug related convictions?

YES

NO

 

 

If yes, you must provide physician verification that the problem is under control or proof of completion of a rehabilitative treatment program

 

 

COMMERCIAL

Are you domiciled (permanent residence) in the State of Alaska?

YES

NO

DRIVERS ONLY

 

 

 

 

 

I acknowledge that receiving an Alaska Permit, License or ID card may cancel or invalidate any Permit, License or ID card from another state per the laws of that state. I have personally reviewed the information on this application and certify under penalty of perjury that to the best of my knowledge and belief the information on this application is true and correct. NOTE: Making a false statement in connection with this application may be punishable by a maximum penalty of $50,000 or five years imprisonment or both per AS 11.46.505.

X

Signature of Applicant (MUST SIGN IN FRONT OF A DMV REPRESENTATIVE)

Date

AMVC ID / Office Number

*****DMV USE ONLY *****

VISION

With CL

Left

Both

Right

Vision Notes

CDL Color Blind Test:

TEST

Without CL

20/

20/

20/

 

Pass / Fail / Medical Card

LICENSE

Orig Renew Duplicate

ISSUED

Class:

 

DOCUMENTS SEEN / OTHER NOTES

(Rev.08/14/2017)

Alaska.gov/dmv

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How one can fill in alaska application permit form stage 1

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