Massdot Cdl Road Test Application PDF Details

Did you know that there is an application form for the CDL road test? The Massdot Cdl Road Test Application Form is a great tool to help you prepare for the testing process. In this blog post, we will provide you with more information about the application form and how to use it. We hope that this information will help you feel confident and prepared when taking your CDL road test.

Here is some data that could be handy in case you are trying to learn how much time it'll require you to fill out massdot cdl road test application and just how many PDF pages it includes.

QuestionAnswer
Form NameMassdot Cdl Road Test Application
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesmassachusetts cdl road test, cdl road application, ma cdl road test application, massachusetts road application

Form Preview Example

 

 

 

 

CDL Road Test Application

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GENERAL INFORMATION

 

Eye Color:

Hair Color:

 

 

Weight:

License Class

 

CDL Endorsements Applying For: (For Class A, B, or C)

 

 

MA Assigned License/Permit Number

A B C M

 

Air Brakes Combo Hazmat Passenger

Tank

 

 

 

 

 

 

 

 

 

 

 

 

 

Doubles/Triples

School Bus

 

 

 

 

 

 

 

 

 

 

 

Last Name

First Name

Middle Name

Date of Birth

Month

Day

Year

Sex

M F

Height

Feet Inches

Mailing Address (Where you want us to send your Driver’s License/ID card and future notices from the RMV)

U.S. Post Ofice MAY NOT deliver if your name is NOT on the mailbox.

City/State

Zip Code

Residential Address (Where you actually reside)

Same as above

City/State

Zip Code

REQUIRED INFORMATION (Use additional paper if needed for these questions)

1.Yes No

2. Yes No

3. Yes No

4. Yes No

5. Yes No

6. Yes No

7. Yes No

Do you want to be, or continue to be, registered as an organ

&tissue donor? If yes, the RMV will provide this information to federally-designated organ procurement organizations serving the Commonwealth, and will print this designation on your CDL license.

Are you an active duty member of the U.S. armed forces?

Are you currently licensed to drive in any state, country, or jurisdiction (including the District of Columbia)?

If yes, where?

Class of License

License #

Except for the above, are you currently licensed to drive, regardless of class of license, in any other state, country, or jurisdiction?

If yes, where?

Class of License

License #

In the past 10 years, have you held any class of driver’s license in another state, country, or jurisdiction?

If yes, where?

 

Class of License

 

License #

 

 

 

 

 

 

 

 

 

 

Have you had, or do you have, a license under any other name in this or another state or jurisdiction?

If yes, where?

Class of License

License #

Do you have a cognitive, neurologic, physical, or any other impairment that may affect your functional ability to operate a motor vehicle safely?

8.Yes No

9. Yes No

10. Yes No

11. Yes No

12. Yes No

13. Yes No

Are you currently taking any medication that may affect your ability to safely operate a motor vehicle?

Note: If you answered “yes” to questions #7 or #8, the RMV Branch Representative must contact the Medical Afairs Branch (MAB).

Are you subject to any driver disqualiication under 49 CFR Section 383.51 of the Federal Motor Carrier Safety Regulations?

Is your license or RIGHT to operate suspended, revoked, or canceled under any state’s law?

If yes, where?

Why?

 

Exp. Date:

(Note: If you answered, “yes,” additional documentation may be required)

Is the motor vehicle that you will use for the driving skills test representative of the class of vehicle which you operate or intend to operate?

Do you meet all the driver qualiication requirements of the Federal Motor Carrier Safety Regulations, 49 CFR Part 391? If you answered “Yes” to # 12, do not answer # 13.

If you answered “No” to question #12, do you meet state qualiication standards for a commercial driver?

(If you answer “Yes” to # 13, you agree that you are not allowed to operate in interstate commerce and will be restricted to travel only in Massachusetts on your CDL.)

(The Commonwealth’s medical standards for safe operation of a motor vehicle are found at http://www.massrmv.com/rmv/medical/policies.htm.)

Please Check One

 

Date Examined

PASS

FAIL

REJECT

CDL Road Test Information (To be completed by examiner )

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PARTS OF TEST

 

 

 

 

PASS FAIL

REASON FOR FAILURE OR REJECTION

 

 

COMMENTS

1.

Pre-Trip

 

 

 

 

 

 

 

 

 

 

 

Restriction Code Add Delete

2.

Air Brake

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3.

Forward & Back (Ofset Alley)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4.

Parallel Park (Conventional)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5.

Parallel Park (Sight Side)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6.

Alley Dock

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7.

Road Test

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Examiner Name

 

Examiner ID #

 

 

Location

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Examiner Signature

Batch Number

 

 

 

- Please complete REQUIRED Sponsor Information and SIGNATURE Section on reverse side -

T21845_0215

APPLICANT REQUIREMENTS

Applicants must meet all of the following requirements for a Class A, B, or C road test in order to be tested:

Have a current driver’s license, if you are seeking additional endorsements.

Have a valid CDL permit, with proper endorsements for the vehicle used.

Have completed CDL self-certiication and provided a valid U.S. Department of Transportation (DOT) medical card or medical waiver.*

Have a completed road test application. (If you answered YES to question 4, 6, or 7 on the road test application, the application must be approved by an RMV branch manager or an authorized RMV employee before the road test.)

Be on time for the skills test. If you are late, you will not be examined. If you must cancel or reschedule your appointment with less than 72 hours notice, you will be responsible for the skills test fee.

SPONSOR INFORMATION

Please be aware that as a sponsor you are subject to Chapter 90 Section 8B, which states in part :

“Such licensed operator shall be liable for the violation of any provision of this chapter, or of any regulation made in accordance herewith, committed by such persons with a learner’s permit; provided, however, that an examiner in the employ of the registrar, when engaged in his oficial duty, shall not be liable for the acts of any person who is being examined by said examiner.”

Sponsors must also meet the following requirements:

1.At least 21 years old.

2.Has a valid U.S. Commercial Driver’s License with proper endorsements for the class of vehicle that you are using.

3.Has a current DOT medical card. (If the sponsor does not have a current DOT medical card, he/she will be subject to a ine.* The test, however, will still proceed.)

*A DOT medical card is not required for a state or municipal employee using a state or municipal vehicle.

Sponsor License Number

Expiration

Class

State

Sponsor Printed Name

Sponsor Signature

Date

VEHICLE REQUIREMENTS

Vehicles used for a Class A, B, or C road test must meet the following requirements. Vehicles not meeting the following requirements will be refused/rejected.

Represent the type and class of vehicle you will be driving when you receive your CDL. For a Passenger Endorsement, the applicant must have the appropriate class vehicle designed to carry 16 or more passengers, including the driver.

Be able to pass a safety check. Vehicles with unstable, dangerous, or HAZMAT loads will be rejected. The vehicle must be completely free of hazardous material.

Have a valid registration and current inspection sticker.

Have adequate seating next to the operator for the use of the examiner.

Have a manufacturer’s gross vehicle weight rating (GVWR) on the vehicle, appropriate for the class of license for which you are applying. If there is no GVWR on the vehicle, you must have a document from the manufacturer or a motor vehicle dealer proving the GVWR.

Vehicle Make/Year

Tractor Registration Number/GVWR State

Trailer Make/Year

OUT-OF-STATE REGISTERED VEHICLES, TRAILERS, AND SEMI TRAILERS

Trailer Registration Number/GVWR

State

Carry proof of insurance coverage in the form of a policy or letter from the insurance company specifying the limits of coverage. The insurance coverage MUST be equal to Massachusetts minimum requirements of $20,000/$40,000P bodily injury and $5,000 property damage coverage for the vehicle’s use in Massachusetts. (No faxes or photo copies.)

RENTAL VEHICLES

Have the rental agreement and written permission on the rental company’s letterhead authorizing use of the vehicle for the road test.

CERTIFICATION AND SIGNATURE OF APPLICANT [Signature is Required]

I understand this Application will be processed through the National Driver Register (NDR) and the Commercial Driver License Information System (CDLIS) to verify the status of my operating privileges in other states and that my Social Security Number (SSN) will be veriied with the Social Security Administration. I also understand that Federal law requires the Registrar to check my driving records in all jurisdictions where I have been licensed in the past 10 years and to respond to similar requests from other states and Cana- dian territories and provinces, from employers or prospective employers, and from insurers, as applicable and that other requests may be governed by the federal Driver Privacy Protection Act. I consent to the release of these records.

I have reviewed this completed Application Form and hereby apply for a Commercial Driver License (CDL) road test. I certify under the penalties of perjury that the informa- tion I have provided in this Application Form is true and complete. I am aware that false statements are punishable by ine, imprisonment, or both under M.G.L.

Chapter 90, Section 24.MA Assigned CDL Permit/License Number

Signature:___________________________________________________________Date:_____________________________

[The Registrar reserves the right to recall any permit or license if it is later determined that the applicant was not qualiied for such permit or license.]

Oficial Notice: Massachusetts law requires persons convicted of a sex offense to register with their local police departments. For information, call 1-800-93MEGAN.

For customer service: Contact our Phone Center at 857-368-8000

Weekdays 9 a.m.- 5 p.m.

Please visit our website for more information

www.massrmv.com

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