Form D401 – Fill Out and Use This PDF

Application Form – D401

Driving Licence

This form allows you to apply for a driving licence if you:

•Have passed a driving test within the last two years

•Hold a driving licence that is due to expire within three months and you want to renew it

• Held a driving licence that expired less than 10 years ago and you want to renew it

• Are exchanging a driving licence issued by another EU Member State or any other country with which Ireland has an exchange arrangement

•Are replacing a lost/stolen or damaged licence

•Are changing personal details on your current licence

Please read guidance notes attached before completing this form. Please complete this form in Block Capitals using a Black Ballpoint pen.

If you are known by a name other than above please complete below

4. Known as

If your name has changed since the last licence issued please complete below

6.Address

Town/City County Place of birth

If born in Ireland please state county. If abroad please state country above

Part 2. Licence Details (see note 3)

13. Licence category required

B

BE

AM

A1

A2

A

D1

D

D1E

DE

C1

C

C1E

CE

W

14. Application type

Page 1 of 10

If you answered ‘Yes’ to any of the above questions 22 to 43 or 44(b) you will be required to submit a medical report (D501) with your application.

1A transient ischemic attack (TIA) is an event, with stroke symptoms that lasts less than 24 hours before disappearing (sometimes called a mini-stroke). While TIAs generally do not cause permanent brain damage, they are a serious warning sign of stroke.

2An Implantable Cardioverter Deibrillator (ICD) is an electronic device which monitors your heart continuously. The ICD is programmed to detect abnormally fast or slow heart rhythms.

3If in doubt please consult your family doctor.

Please proceed to Part 6 on page 5 and complete Questions 45 and 46.

Please also ensure to sign the Declaration in the white box at the bottom of page 5. This signature will appear on your new licence. Please ensure to sign using a Black Ballpoint pen and keep your signature within the white space.

Page 3 of 10

MOTOR TAX OFFICES CONTACT NUMBERS FOR PUBLIC ENQUIRY

County Council	Address		Phone Number	Email
Carlow	Athy Road, Carlow		059 9170342	motortax@carlowcoco.ie
Cavan	Courthouse, Cavan		049 4378430	motortax@cavancoco.ie
Clare	1.	New Road, Ennis	065 6844661	motortax@clarecoco.ie
	2. Ennistymon Ofice		065 7071017
Cork	Model Business Park, Model Farm Road, Cork		021 4544566	motortax@corkcoco.ie
Dublin City	1.	Block B, Blackhall Walk, Queen Street, Dublin 7	01 2228000	motortax@dublincity.ie
	2.	9th Lock Road, Clondalkin	01 2228300
	3.	Ballymun Civic Centre, Main Street, Ballymun	01 2228250
Donegal	1.	The Three Rivers Centre, Lifford	074 9153900	motortax@donegalcoco.ie
	2.	Neil T. Blaney Road, Letterkenny
	3. Malin Road, Carndonagh
	4. Gweedore Road, Dungloe
	5.	Main Street, Milford
	6. Drumlonagher, Donegal Town
Galway	1.	County Hall, Prospect Hill, Galway	091 509099	motortax@galwaycoco.ie
	2.	Civic Ofices, Bridge Street, Ballinasloe	090 9648090
	3. An Cheathrú Rua		091 595788
Kerry	Rathass, Tralee		066 7122300	motortax@kerrycoco.ie
Kildare	Áras Chill Dara, Devoy Park, Newbridge Road, Naas		045 980591	motortax@kildarecoco.ie
Kilkenny	County Hall, John’s Street		056 7794100	motortax@kilkennycoco.ie
Laois	County Hall, Portlaoise		057 8664009	corpaffairs@laoiscoco.ie
Leitrim	Áras an Chontae, Carrick-on- Shannon		071 9620005	mtax@leitrimcoco.ie
Limerick	Lissanalta House, Dooradoyle		061 496500	mto@limerickcoco.ie
Limerick City	City Hall, Merchant’s Quay		061 407100/407112/407256	motortax@limerickcorp.ie
Longford	Great Water Street		043 3343400	motortax@longfordcoco.ie
Louth	1.	Millennium Centre, Dundalk	042 9353170	motortax@louthcoco.ie
	2.	Fair Street, Drogheda	041 9876160	droghedashop1@louthcoco.ie
Mayo	1.	Glenpark, The Mall, Castlebar	094 9047600	motortax@mayococo.ie
	2.	Belmullet	097 81004
	3.	Ballina	096 76100
Meath	County Hall, Navan		046 9022416	motortax@meathcoco.ie
Monaghan	Market Street, Monaghan		047 81175	motortax@monaghancoco.ie
Offaly	Áras an Chontae, Charleville Road, Tullamore		057 9346831	motortax@offalycoco.ie
Roscommon	Abbey Street		090 6637250	motortax@roscommoncoco.ie
Sligo	1.	Cleveragh Retail Park	071 9111830	motortax@sligococo.ie
	2.	Tubbercurry one-stop	071 9111706
North Tipperary	Civic Ofices, Limerick Road, Nenagh		067 44701	motortax@northtippcoco.ie
South Tipperary	1.	Emmet Street, Clonmel	052 6134444	motortax@southtippcoco.ie
	2.	Friar Street, Cashel	062 64700	cashelmotortax@southtippcoco.ie
Waterford County	Shandon Road, Dungarvan		058 22087	motortaxinfo@waterfordcoco.ie
Waterford City	The Deanery, Cathedral Square		051 309900	motortax@waterfordcorp.ie
Westmeath	1.	County Buildings, Mullingar	044 9332182	secretar@westmeathcoco.ie
	2.	Main Street, Athlone	090 6442187
Wexford	Carricklawn, Wexford		053 9196333	motortax@wexfordcoco.ie
Wicklow	County Buildings, Wicklow		0404 20118	motortax@wicklowcoco.ie

Page 4 of 10

Do not attach your photo

Part 6. Declaration By Applicant – Tick boxes below (see note 10)

45.I hereby declare that

Ireland is my normal place of residence (see note 2)

I am not currently disqualiied from holding a learner permit or driving licence

The address given is my normal place of residence

The accompanying photographs and supporting documents relate to me

46.If your licence was lost/stolen or damaged and is unreadable, please have the Garda declaration below stamped at your local Garda Station (see note 3)

Checklist

Your application for a driving licence should include:

In all cases

• A completed signed application form

• Two photographs on white background – signed on back (see note 8)

• Your current or most recent driving licence and/or learner permit (see note 3)

• The appropriate fee (see note 9)

And if required in your case (Please see guidance notes)

• An original birth certiicate (see note 2)

• Photographic identity (see note 2)

• Evidence of address (see note 2)

• An eyesight report (see note 7)

• A medical report (see note 7)

• Pass driving test certiicate (see note 3)

• Evidence of change of name (see note 3)

• Certiicate of Professional Competency (CPC) theory test and practical knowledge test (see note 3)

• Certiicate of Satisfactory Completion Initial Basic Training (Motor Cycles)

THIS DECLARATION MUST BE SIGNED BY THE PERSON TO WHOM THE LICENCE IS TO BE ISSUED

Applicant’s Signature:

(please keep signature within box)

This signature will appear on your licence.

You must use a Black Ballpoint pen or your application may be returned.