Form CDL-5 at a glance
What it is: Form CDL-5 (Rev. 1/12) is the State of North Carolina Division of Motor Vehicles application and certification for a commercial driver license.
Who signs: Sign on the Signature line and enter the Date.
A filled-in Form CDL-5 example: a new applicant for a Class B CDL
How to fill out Form CDL-5, box by box
Name, license number and date of birth
Mark Original, Renewal or Duplicate, then enter your Name (Last) (First) (Middle) (Suffix).
Enter the North Carolina License Number, Social Security Number and Date of Birth, then mark Race: White, American Indian, Black or Other.
Height
Enter Height in Ft. and In.
Residence address and mailing address
Enter the Residence Address and the Mailing Address, each with City, State, Zip and County.
Class CDL applying for, endorsements and organ donor
Mark the Class CDL Applying For (A, B or C) and the Endorsements (H, T, S, P, N, X or M).
Mark Organ Donor Yes or No.
Transferring to North Carolina
Mark Are you transferring to North Carolina? Y or N. If yes, list all states and license numbers where you have been licensed in the last 10 years.
Initial the certifications
You must certify that you operate or expect to operate in one of the applicable certifications.
NON-EXCEPTED INTERSTATE (1): operates or expects to operate in interstate commerce, is both subject to and meets the qualification requirements under 49 CFR part 391, and is required to obtain a medical examiner's certificate by 391.45.
EXCEPTED INTERSTATE (2): operates or expects to operate in interstate commerce, but engages exclusively in transportation or operations excepted under 49 CFR 390.3(f), 391.2, 391.68 or 398.3 from all or parts of the qualification requirements of 49 CFR part 391, and is, therefore, not required to obtain a medical examiner's certificate.
NON-EXCEPTED INTRASTATE (3): operates only in intrastate commerce and, therefore, is subject to State driver requirements.
EXCEPTED INTRASTATE (4): operates in intrastate commerce but, engages exclusively in transportation or operations excepted from all or parts of the State driver qualification requirements.
All applicants must initial Items 5 and 6. Only initial line 7 when a skills test is required.
You certify (5) that you are not subject to disqualification under Title 49, Code of Federal Regulations, Part 383.51, of any license suspension, revocation, or cancellation under State Law.
You certify (6) that you do not have a driver's license from more than one state or jurisdiction.
You certify (7) that the vehicle in which you will take the commercial motor vehicle skills test is representative of the type and size motor vehicle you operate or expect to operate.
Signature
You certify that the information provided in this application is correct and true to the best of your knowledge, and that your signature represents consent to release your driving record information.
Supplying false information may result in the suspension of your driving privilege.
The application fee required when submitting this application is non-refundable, and all test scores are valid for 90 days.
More rules for Form CDL-5
Mark Sex: Male or Female.
Mark U.S. Citizen Yes or No, then Hair Color and Eye Color.
Sources
[1] Form CDL-5 (Rev. 1/12), Application / Certification for Commercial Driver License, North Carolina Division of Motor Vehicles (the Official source link on this page).