Dmv Form 735 173 PDF Details

Dmv Form 735 173 is a document you will need to complete in order to request a duplicate copy of your driving record. This form can be used to request a transcript or certified copy of your driving record. The Department of Motor Vehicles provides several methods for you to request your driving record, including online, by mail, and in person. Be sure to submit the correct form and payment method to ensure that your driving record is processed quickly.

You may find details about the type of form you intend to prepare in the table. It will show you how much time you will need to complete dmv form 735 173, what parts you will have to fill in, and so forth.

QuestionAnswer
Form NameDmv Form 735 173
Form Length2 pages
Fillable?Yes
Fillable fields52
Avg. time to fill out10 min 58 sec
Other namesoregon application for drivers license form, oregon dmv form 735 173, form 173, oregon driver's license application

Form Preview Example

SIGNATURE OF BIOLOGICAL OR ADOPTIVE MOTHER OR FATHER – OR
X
SIGNATURE OF APPLICANT
X
ORS 807.060 requires the signature of the applicant’s mother, father, or legal guardian if an applicant for driving privileges is under 18 years of age. Proof of legal guardianship is required.

 

 

 

 

 

 

 

 

 

APPLICATION FOR DRIVING PRIVILEGES OR ID CARD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DM V

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ORIGINAL

RENEWAL

REPLACEMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVER LICENSE

 

CLASS C

LT

CLASS C RESTR'D CONVERT

INSTRUCTION PERMIT

CLASS C

MOTORCYCLE

MOTORCYCLE

ENDORSEMENT 3-WHEEL

ID CARD

AT-RISK

LAST NAME (PRINT NAME)

FIRST NAME

MIDDLE NAME

SOCIAL SECURITY NUMBER

DRIVER / ID NUMBER

DATE OF BIRTH (M-D-Y)

MOTHER'S MAIDEN NAME

APPLICANT’S PLACE OF BIRTH (CITY & STATE OR COUNTRY)

 

 

 

 

RESTRICTIONS

Do you want your license or ID card to show that

 

YES WEIGHT

HEIGHT

 

SEX (CIRCLE) HAIR COLOR EYE COLOR

 

you are an anatomical donor?

 

NO

LBS.

FT.

IN.

M F

 

 

 

 

 

 

 

 

 

 

RESIDENCE ADDRESS

 

 

 

MAILING ADDRESS (IF DIFFERENT FROM RESIDENCE ADDRESS)

CITY, STATE, ZIP CODE

CITY, STATE, ZIP CODE

CURRENT OR PREVIOUS MILITARY SERVICE: By checking this box I authorize DMV to send my name and address to the Oregon Department of Veterans' Affairs (ODVA) for the purpose of receiving benefit information.

Do you now have or have you ever had, an Oregon driving privilege or

 

 

YES

WHEN

WHERE / NUMBER

NAME ON PREVIOUS LICENSE / CARD

ID card or a driver license or permit from another state or country

 

 

 

 

 

 

 

NO

 

 

 

issued in your current name or any other name?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Are you currently or have you ever had your privilege to drive or right to

 

 

YES

WHEN / WHERE

REASON

 

 

 

 

 

 

 

 

 

 

apply for the privilege suspended, revoked, canceled or refused?

 

 

NO

 

 

 

 

 

 

 

 

 

 

You are required to report any mental or physical condition or impairment that affects your ability to drive safely. You are not required to report all your health conditions – only those that affect your ability to drive safely. DMV will use your answers to the following questions only for the purpose of determining your eligibility for an Oregon driving privilege. If you have a condition or impairment that makes you unable to safely operate a motor vehicle, you are not eligible for a driving privilege until you have provided additional medical information and/or passed DMV tests. If you answer “Yes” to any one of the questions below, we will not be able to issue you a license at this time.

1)

Do you have a vision condition or impairment that has not been corrected by glasses, contacts or surgery that affects your ability to drive safely?

 

 

YES

NO

 

 

 

 

2)

Do you have any physical or mental conditions or impairments that affect your ability to drive safely?

 

 

YES*

NO

 

 

 

 

 

 

 

 

*If Yes: a) What is the condition or impairment?: _______________________________________________________________________________________________

 

b) Describe how this affects your ability to drive safely: ___________________________________________________________________________________

3)

Do you use alcohol, inhalants, or controlled substances to a degree that affects your ability to drive safely?

 

 

 

 

 

 

 

YES*

NO

 

 

 

 

 

 

 

 

*If Yes: a) Describe how your use affects your ability to drive safely: _______________________________________________________________________________

I understand: DMV will cancel or suspend my permit, license or ID if I make any false statement or show false evidence of age, identity, legal presence, Social Security number, full legal name, and/or residence address on this application. If I am convicted of such act(s), I can be fined and/or sentenced to jail. Disclosure of my Social Security number is mandatory and may be used for: enforcing child support laws; verifying identity and residency; and by other government agencies who request it from DMV. (ORS 25.785, ORS 807.021, ORS 807.050, OAR 735-

062-0005). I certify the vehicle I will use for the license test has insurance coverage meeting the requirements of ORS 806.060. I also certify that I am a resident of or domiciled in Oregon as required by ORS 807.062 and ORS 807.400.

For applicants under 18 years of age and their parent or legal guardian: the signatures on this application certify the applicant has complied with the driving experience requirements under ORS 807.065(1)(2) if applying for a class C license. (Check ONE of the following.)

50 hours of supervised driving and completed an ODOT - approved traffic safety education course

100 hours of supervised driving

Out-of-State license

LEGAL GUARDIAN

STOP - DO NOT WRITE IN THE AREA BELOW - FOR DMV OFFICE USE ONLY

OUTSTANDING REQUIREMENTS

 

DATE RECEIVED

TSR ID

 

 

 

LP or ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REIN. FEE/SR-22

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OTHER:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STATEMENT OF ENROLLMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

KNOWLEDGE TEST

 

 

 

DATE STAMP

TEST

SCORE

 

TSR ID

 

 

 

 

 

 

 

DATE STAMP

TEST

SCORE

 

TSR ID

 

 

 

 

 

 

 

DATE STAMP

TEST

SCORE

 

TSR ID

 

 

 

 

 

 

 

 

 

VISION / HEARING

VISION: OK

OK W/BIOPTIC

HEARING:

GOOD DEAF

 

OK/WCL

LENSES

 

 

 

 

 

 

 

F RESTRICTION

G RESTRICTION

 

 

 

 

 

 

DATE

 

 

TSR ID

REFERRED: ACUITY F.O.V.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVE TEST

 

 

 

 

1

DATE

 

 

CLASS

SCORE

 

 

TSR ID

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

DATE

 

 

CLASS

SCORE

 

 

TSR ID

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3

DATE

 

 

CLASS

SCORE

 

 

TSR ID

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DOCUMENTS PRESENTED

DOCUMENTS PRESENTED

DOCUMENTS PRESENTED

US BIRTH CERTIFICATE/PASSPORT/PASSPORT CARD

US BIRTH CERTIFICATE/PASSPORT/PASSPORT CARD

US BIRTH CERTIFICATE/PASSPORT/PASSPORT CARD

FOREIGN PASSPORT & DHS DOC. or ADMIT. STAMP

FOREIGN PASSPORT & DHS DOC. or ADMIT. STAMP

FOREIGN PASSPORT & DHS DOC. or ADMIT. STAMP

DHS DOCUMENT

DHS DOCUMENT

DHS DOCUMENT

OTHER (Specify) _________________________

OTHER (Specify) _________________________

OTHER (Specify) _________________________

LP=C LP=F LP=P LP=U

LP=C LP=F LP=P LP=U

LP=C LP=F LP=P LP=U

 

 

 

DATE

TSR ID

2nd CHECK

DATE

TSR ID

2nd CHECK

DATE

TSR ID 2nd CHECK

 

 

DATE STAMP

 

 

FEE

TSR ID

 

 

 

 

$

735-173 (6-15)

STK# 300093

DRIVE TEST SCORE SHEET

 

COURSE

 

 

 

 

 

 

 

 

 

 

DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PLATE / TEMP.

 

 

 

 

 

 

 

 

REPRESENTATIVE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INSURANCE INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INSURANCE CO.

EXPIRATION DATE

INSURANCE CO.

 

 

EXPIRATION DATE

INSURANCE CO.

 

 

EXPIRATION DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

POLICY NUMBER

 

 

POLICY NUMBER

 

 

 

POLICY NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A. Starting

 

 

 

 

1

2

3

F. Speed

 

 

 

1

 

2

3

 

 

 

 

 

 

 

 

 

 

...........................................................................

 

5-25

 

 

 

 

1.

Signal

 

5-10

 

 

 

1.

Too fast

 

 

 

 

 

 

 

 

 

 

 

 

 

 

.........................................................................

 

5-25

 

 

 

 

2.

Observation - ahead, side, rear

 

5-25

 

 

 

2.

Too slow

 

 

 

 

B. Stopping

 

 

 

 

 

 

 

G. Attention

 

 

 

 

 

 

 

1.

Too suddenly

 

5-10

 

 

 

1.

Intersection, RR, driveway

10-25

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

.....................................................................

 

5-25

 

 

 

 

2. Unnecessary

 

5-15

 

 

 

2.

Other traffic

 

 

 

 

 

 

 

 

 

 

 

 

 

.....................................................................

 

5-25

 

 

 

 

3. On crosswalks - in intersections

.....................................

 

5-10

 

 

 

3.

Pedestrians

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

..........................................................

 

5-25

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4.

Strays from driving

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5.

Reacts slowly in emergency

5-25

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

C. Turning

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1.

Signal

 

5-10

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

From wrong lane - one-way, two-way

5-25

 

 

 

H. Driving attitude

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

.....................................

 

5-25

 

 

 

 

3.

Into wrong lane - one-way, two-way

5-25

 

 

 

1.

Depends upon others for safety

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

......................................

 

5-25

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4.

Swings wide - cuts corner

 

5-20

 

 

 

2.

Too aggressive - inconsiderate

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

............................................................

 

5-25

 

 

 

 

5.

Speed

 

5-20

 

 

 

3.

Fails to anticipate

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6.

Observation - ahead, side, rear

 

5-25

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D. Lane Use/Change

 

 

 

 

 

 

 

I. Miscellaneous

 

 

 

 

 

 

 

1.

Signal

 

5-10

 

 

 

I. Inexperience, improper vehicle control, traffic

5-25

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

...................................................................

 

5-30

 

 

 

 

2.

Observation - ahead, side, rear

 

5-25

 

 

 

2.

Right-of-way

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

...............................

 

10-25

 

 

 

 

3.

Position - right, left, drift

 

5-20

 

 

 

3.

Too close - following, stopping, side

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

............................................................

 

5-25

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4.

Backing - parking

 

 

 

 

E. Signs and Signals

 

 

 

 

 

 

 

5.

Passing

5-25

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1.

Proceeded through - stopped by examiner

10-30

 

 

 

6.

Posture

5-10

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

........................................................................

 

5-20

 

 

 

 

2.

Rolled through

 

5-25

 

 

 

7.

Freeways

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

Observation

 

5-20

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4.

Improper maneuver

 

5-15

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Grounds For Immediate Failure

 

 

TOTAL DEDUCTIONS

1

2

 

 

3

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1. An accident involving any amount of property damage or personal injury.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2. The applicant refuses to perform any maneuver which is part of the prescribed

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SCORE

 

 

 

 

 

 

 

 

driving test.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3. Any dangerous action in which:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

a.An accident is prevented by expert driving or action on the part of other drivers.

b.The examiner is forced to assist the driver in avoiding an accident physically or orally.

c.The applicant drives or backs over curb or sidewalk.

d.The applicant creates a serious traffic hazard by stalling or other improper driving behavior.

4.The applicant commits any of the following:

a.Passes another car which is stopped at a crosswalk, yielding to a pedestrian, or passes a school bus stopped with its red lights flashing.

b.Makes or starts to make a turn into or from the wrong lane under traffic conditions that render such actions dangerous.

c.Runs through or has to be stopped from running one red light or one stop sign.

5.Applicant is unable to properly operate vehicle equipment or, after proceeding a short distance on the drive course, it becomes apparent that the applicant is dangerously inexperienced.

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