Form D401 – Fill Out and Use This PDF

Part 1. Personal Details (see note 2)

2.First name(s)

3.Surname

Ms

Other

5. Previous name

Reason for name change

Irish name

Divorce/Separation

(see note 2)

7.Gender

8.Contact number

(mobile preferred)

9.Date of birth

10.PPSN

11.Email

12.Notiication

This will help us to send you information relating to your licence

If your licence was lost/stolen or damaged you must complete the declaration in part 6 in your local Garda station

Please specify __________________

No

(You will ind this at 5 on a paper licence/permit or at 4d on a plastic permit/licence)

Part 3. Exchanging a Driver’s Licence (see note 5)

Issuing country

Issuing authority

Driving licence no.

18. Has the licence you are exchanging for an Irish licence previously been exchanged for a licence in another country? Yes If ‘Yes’, please state the country where licence was previously exchanged

No

19. I took up normal residence in Ireland on

Part 4. Organ Donation (see note 6)

20. Tick here if you would like a code on your licence indicating your wish to become an organ donor.

Part 5. Driver Fitness (see note 7)

Eyesight

21. Do you need to wear glasses or lenses for driving?Yes

If in the past you answered ‘Yes ‘ to this question and are now answering ‘No’ you must provide an eyesight report (D502) with your application

No

Health and Fitness

Page 2 of 10

No

No

No

No

No

No

No

No

No

No

No

No

No

No

No

No

No

No

No

No

No

No

No

No

Office Use Only

Driver Number

Date of Birth (DDMMYYYY)

Serial Number

Remarks

Office

Use

Only

Date of Application:

D D M M Y Y Y Y

Guidance Notes for Completion of your Licence Application Form

1 INTRODUCTION

In Ireland a driving licence is issued to drivers who pass a driving test while learner permits are for those learning to drive. This form is for a driving licence and lets you:

•Apply for a irst time licence or renew an existing licence (complete all parts of the form).

•Replace a lost, stolen or damaged licence (complete parts, 1,2, 4, 5 and 6 of the form). Where the damaged licence can be enclosed and is readable it will not be necessary to have the Garda declaration at part 6 completed.

•Add on new licence categories after you pass a driving test (complete all parts of the form). If the new categories are Group 2 vehicles (e.g. trucks and buses) then you will have to complete a medical report (D501) from your Doctor – see note 7.

•Advise of a change to your health that affects your driving (complete all parts of the form).

•Advise of a change of personal details, (e.g. name or address – complete parts 1,2, 4 and 6 of the form).

•Exchange a licence from another country for an Irish one (complete all parts of the form). See note 7 to see if you need to complete part 5 in your case.

2 PERSONAL DETAILS

All of the information requested in this part is necessary and must be completed in full. In accordance with rules on data protection your data may be shared with other State Agencies to enable your identity and entitlement to a licence to be veriied. We may from time to time contact you by email or text with information about your driving licence. We will not give your information to any third party except in accordance with the law.

To apply for a licence you must be normally resident in Ireland; this generally means that you live here at least

185 days each calendar year because of work or personal ties. If you are studying or working abroad you may still be considered normally resident in Ireland provided you return here regularly. Where a person lives some part of the year outside of Ireland the question of personal, family and community ties helps determine whether or not you are normally resident.

Your address should be the place at which you are normally resident; for a student this generally means a family home. If you are applying for a personal details change on an existing licence please see note 3.

PPSN is a Personal Public Service Number, which is a unique identiier that helps you access state beneits. If you do not have a number or are unable to trace it please contact the Department of Social Protection and they will give you the necessary information. PPSN is mandatory and must be completed.

Where you already hold or held an Irish licence or learner permit and your personal details have not changed we will not normally need evidence of identity unless reporting licence lost or stolen. We will contact you directly if we need more information. Where you have not previously held an Irish licence or learner permit you must submit photo identity, evidence of age and conirmation of your address. Acceptable photo identity documents are Passport, Department of Social Protection Services Card, Garda National Immigration Bureau Card and EU Identity Card. Acceptable evidence of address includes utility bills (e.g. electricity, gas and telephone providers), as well as bank, credit union or credit card statements. Evidence of age must be provided by submitting your original birth certiicate or current passport. We will return the documents directly to you once validated.

3 LICENCE DETAILS

This part of the form tells us why you are applying for a licence. It will mean in some cases you will have to give us some supporting documents.

The licence type required is for the vehicle you want to drive. The table in this note will give you the vehicle category description for each vehicle.

•If you are applying for a irst time driving licence you have to enclose your learner permit and your pass driving test certiicate (Certiicate of Competency), or in some cases for motorcycles a Certiicate of Satisfactory Completion Initial Basic Training (Motor Cycles). If you do not have your learner permit you must get the Garda declaration in part 6 stamped at your local Garda station.

•If you are renewing your licence you must include your most recently issued driving licence. If you do not have your licence you must get the Garda declaration in part 6 stamped at your local Garda station.

•If you are adding extra licence categories to your existing licence please enclose your pass driving test certiicate (Certiicate of Competency), or in some cases for motorcycles a Certiicate of Satisfactory Completion Initial Basic Training (Motor Cycles). You may also need a medical report (form D501) – see note 7.

•If your licence/permit was lost or stolen you must have the Garda declaration in part 6 of the form stamped at your local Garda station – see note 2.

•If you are replacing a damaged licence please enclose the damaged licence; if unable to do so you must have the Garda declaration in part 6 of the form stamped at your local Garda station.

•If you are applying for a name or address change, you must supply supporting information, (e.g. marriage certiicate, divorce/separation conirmation, deed poll conirmation). Original documents are needed in each case. In the case of an address change please supply copy of a utility bill (copy of online bill will be accepted) with your name and new address.

•If a medical condition affects your driving you will need a medical report (D501) completed by your Doctor –

see note 7.

Table – Summary Description of Licence Categories

•If you are exchanging your licence for an Irish one you must surrender the licence being exchanged. This licence will be sent to the country of issue by us when your Irish licence issues.

It is against the law to hold another EU licence at the same time as the licence for which you are now applying. Question 15 asks you to conirm that you do not hold two licences at the same time.

The Table below describes each vehicle in a licence category. This will help you identify the licence that you want to apply for.

From 19 January 2013 licensing rules for some vehicles/ drivers have changed. For more on this and other general licensing information please check our website www.rsa.ie

MAM1 Maximum Authorised Mass (also known as Design Gross Vehicle Weight D.G.V.W) means design laden weight. Manufacturers generally refer to it as gross vehicle weight (g.v.w.) and it is usually displayed on a metal plate attached to the vehicle by the manufacturer.

A person applying for a truck licence in category C or CE must be aged 21 before taking out a licence; the exception to this is that a licence at minimum age 18 can be applied for where a Certiicate of Professional Competence (CPC) is being applied for as part of the licence. A person applying for a bus licence in category D or DE must be aged 24 before taking out a licence; the exception to this is that a licence at minimum age 21 can be applied for where CPC is being applied for as part of the licence. More information on CPC can be found on www.rsa.ie/cpc.

4 PERIOD OF LICENCE

A driving licence for Group 1 vehicles (covering works vehicles, cars and motorcycles) normally lasts for a period of 10 years. There are some exceptions to this rule – if you are over 70 years of age or have a medical condition a licence for three years or for a shorter period may be speciied by your Doctor. If you are over age 60 your licence will be granted up to age 70, if you are aged over 67 but less than 70 years of age a three year licence will be granted.

A driving licence for Group 2 vehicles (trucks, buses and articulated vehicles) normally lasts for ive years.

5 EXCHANGING A LICENCE

You can exchange any licence from another EU country, from the following EEA countries: Iceland, Liechtenstein and Norway and from the following recognised states: Australia, Japan, New Zealand, South Africa, South Korea, Switzerland and Taiwan.

You must surrender the exchange licence with your application for an Irish licence. Where you are exchanging an EU licence the licence can have expired for up to ten years, while a licence from a recognised state or an EEA country can have expired for no more than one year to be eligible for exchange. You must also provide details if the licence you want to exchange was issued following an earlier exchange. If you are exchanging a licence which includes Group 2 vehicles (e.g. trucks and buses), or if you suffer from a condition set out in part 5 of the application form that requires a medical report (D501) then you must include a medical report with your application. Where the licence being exchanged is from a country outside the EU you must include an eyesight report (D502) with your application. Photo identity must be produced.

6 ORGAN DONATION

If you wish to donate your organs you can record this on your licence. The licence will contain a code that will make medical professionals aware of your intention. However, in keeping with the current legal position, your next of kin will be consulted in the event of any decision of this nature.

7 HEALTH AND FITNESS TO DRIVE

Drivers must meet a certain standard of medical itness in order to drive safely. If your Doctor advises you to stop driving it is then an offence to continue driving and it also affects your insurance cover. A higher standard of medical itness is needed for drivers of trucks or buses, described as Group 2 drivers as opposed to drivers of cars, motorcycles or works vehicles who are described as Group 1 drivers.

For more information on medical standards for Group 1 drivers see “Sláinte agus Tiomáint” document on www.rsa.ie. A similar document for Group 2 drivers will be available shortly.

•Every driver over the age of 70 applying for a licence must provide a medical report (D501) from a Doctor with an application for a driving licence.

•Every Group 2 licence application must include a medical report (D501) from a Doctor.

•Where questions under Health and Fitness in part 5 of the application form are answered ‘Yes’ a medical report (D501) will be needed.

•On the basis of the information on your application form the licensing authority can ask you to submit a medical report (D501) from your Doctor. Your Doctor must be registered on the General Register of Medical Practitioners in Ireland.

An eyesight report (D502) is not required where a medical report is provided unless indicated by the Doctor. Medical Form (D501) and Eyesight Form (D502) can be downloaded from www.rsa.ie or you can get copies in your local Motor Taxation Ofice.

Some questions in part 5 of the application form may require advice from your Doctor in order to be answered. The purpose of the questions is to ensure that you are aware of factors that affect your driving. In some cases having a particular condition may mean that you will be granted a licence for a shorter time period, (e.g. for a one or three year period).

An eyesight report (D502) is needed where you previously wore glasses/lenses and are no longer required to do so. It is also needed in certain cases when exchanging a licence from another country – see note 5.

8 PHOTOGRAPHS

Two identical photographs must be included with your application and both must be signed on the back. As your photograph will be scanned on to your licence it is essential that it meets the standard for driving licences.

•Recent photograph no more than six months old.

•Photographs must be in colour.

•Minimum size 35mm x 45mm, maximum size 38mm x 50mm.

•Photographs must show a full frontal view with the head centred and not tilted in the photographs.

•Photographs must be sharp and clear and taken against a plain white background; a dark background is not acceptable.

•Sunglasses must not be worn, but lightly tinted glasses that show the person’s eyes can be worn. If lighting reflections cannot be removed then the glasses themselves should be removed.

•Head coverings, other than for religious reasons are not allowed and hair bands are not acceptable.

•Photographs must show the whole face including the chin and top of the head.

•Photographs should not have a ‘red eye’ effect.

This photograph is an example of an acceptable photograph for a driving licence. Helpful information on photograph standards that also apply to driving licences is available by visiting www.dfa.ie and clicking on the Passport Photographs link.

9 FEES

The fee for the driving licence is set out below:

Cheques, bank drafts and postal orders for the appropriate fee should be made payable to the Local Authority to which you are applying.

10 DECLARATION

In this part you conirm that all the information given is true and accurate; giving false information is an offence under the Road Trafic Acts and penalties apply. If you are applying for a replacement licence because your licence was lost or stolen or if it was damaged (and cannot be submitted with your application) you must complete the Garda declaration and have it stamped at your local Garda Station.

11 SUBMITTING AN APPLICATION

You should apply to the Motor Tax Ofice in the County/City in which you reside for a driving licence.

12 DATA PROTECTION

Information contained in this form may be subject to disclosure under section 60 of the Finance Act, 1993 (No. 13 of 1993) as amended by section 86 of the Finance Act, 1994 (No. 13 of 1994) and regulations made thereunder. List of disclosees is registered with the Data Protection Commissioner.

13 FURTHER INFORMATION

If you need more information please visit www.ndls.ie or contact your local Motor Taxation Ofice – you will ind the number in the green pages of your local telephone directory.