Question	Answer
Form Name	D1 Dvla Form
Form Length	2 pages
Fillable?	Yes
Fillable fields	136
Avg. time to fill out	27 min 46 sec
Other names	d1 form download, d1 form, dvla d1 form, printable d1 form

Has your name or address (or both) changed	No ■ Yes ■
since your last licence was issued?	No ■ Yes ■
If ‘Yes’, write the previous details below.

or corrective lenses if necessary) from 20.5 metres
(67 feet) or 20 metres (65 feet) where narrower
characters (50mm wide) are displayed?	Yes ■ No ■

Day Month	Year
■■ ■■ ■■■■
Please tick the licence you want.		■
• Provisional

• Replacement
Replace my licence due to a change of name or address			■
(or both). I am enclosing my current driving licence.			■
• Duplicate
My licence has been:
lost or stolen ■	defaced ■	destroyed ■
• Exchange			■
Change my licence following a test pass.			■
Enter categories in the box.
Enter categories in the box.			■
Remove expired endorsements or suspension details.			■
Add provisional motorcycle entitlement.			■
Exchange my paper licence for a photocard licence.			■
Change my photograph.			■
Exchange my Northern Ireland licence.			■
Exchange my foreign licence for a British one.			■
Whichcountryissuedit?
DidyoupassyourtestinthatCountry?		Yes ■	No ■
If ‘No’, which country?
If you passed your test in Canada, was it		Yes ■	No ■
inavehiclewith manual transmission?		Yes ■	No ■

•Renew	■
At age 70 or over	■
For medical reasons	■
Revoked under the Road Trafﬁc (New Drivers) Act 1995	■
After disqualiﬁcation	■

Any part of my body ■	Kidneys ■	Corneas ■
Heart ■ Lungs ■	Liver ■	Pancreas ■

• Was your last licence a:		photocard licence?		■	paper licence? ■
• If you have given up driving because you were disqualiﬁed in Great Britain,
please give the date and say which court dealt with it (if known).
Day Month	Year			Court name
■■ ■■ ■■■■
Are you currently disqualiﬁed in any other country?					No ■ Yes ■
If ‘Yes’, which country were you disqualiﬁed in?
If ‘Yes’, which country were you disqualiﬁed in?
What is the expiry date shown on the			Day		Month	Year
What is the expiry date shown on the			■■ ■■ ■■■■
licence or entitlement you are renewing?			■■ ■■ ■■■■
An executive agency of the
Department for Transport						12/03

Have you ever had, or do you currently suffer from
any of the following conditions?	No ■ Yes ■

Post town	Postcode
Place of birth (country)

1	Epilepsy	■
2	Fits or blackouts	■
3	Repeated attacks of sudden disabling giddiness	■
4	Diabetes controlled by insulin	■
5	Diabetes controlled by tablets	■
6	An implanted cardiac pacemaker	■
7	An implanted cardiac deﬁbrillator (ICD)	■
8	Angina (heart pain) which is easily brought on by driving	■
9	Persistent alcohol misuse or dependency	■
10	Persistent drug misuse or dependency	■
11	Parkinson’s disease	■
12	Narcolepsy or sleep apnoea syndrome	■
13	Stroke, with any symptoms lasting longer than	■
	one month, recurrent “mini-strokes” or TIAs	■
14	Any type of brain surgery, severe head injury	■
	involving inpatient treatment, or brain tumour	■
15	Any other chronic neurological condition	■
16	Aserious problem with memory or periods of confusion	■
17	Severe learning disability	■
18	Serious psychiatric illness or mental ill health	■
19	Total loss of sight in one eye	■
20	Any condition affecting both eyes, or the remaining eye
	if you only have one eye	■
	(not including colour blindness or short or long sight)	■
21	Any condition affecting your visual ﬁeld	■
22	Any persisting limb problem which needs
	driving to be restricted to certain types	■
	of vehicle or those with adapted controls	■

Has it got worse since you told us about it?	No ■ Yes ■
Have you had any special controls ﬁtted to...............your	No ■ Yes ■
vehicle since your last licence was issued?	No ■ Yes ■

D1 Dvla Form – Fill Out and Use This PDF

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