Are you currently enrolled in the US Marine Corps? If so, it is important that you become familiar with the Navmc 10964 form which is used for administrative purposes. This comprehensive writing assignment covers a variety of topics related to military service and requires an understanding of several key concepts. In this blog post, we will provide step-by-step guidance on how to fill out the Navmc 10964 form and provide tips to ensure accuracy when submitting it for processing. Whether or not you are already aware of this document's importance, read on to learn more about completing your own version efficiently!
| Question | Answer |
|---|---|
| Form Name | Navmc 10964 Form |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | navmc 10964 updated, dod 11240 7800 fill, where to file form mvd 10964, dod form 10964 |
APPLICATION FOR GOVERNMENT VEHICLE OPERATOR'S PERMIT (11240)
NAVMC 10964 (REV. 296) (EF) (Previous editions are obsolete)
SN: 0109LF0647800 (Supersedes NAVFAC FORM 911240/10 FOR USMC use.)
PART I APPLICATION
|
1. NAME (LAST, FIRST, MIDDLE) |
|
|
|
|
2. RANK |
3. SSN |
|
|
|
|
|
|
4. ORGANIZATION |
|
|
|
|
|
|
|
|||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||||||||||
|
5. SEX |
|
6. HEIGHT |
7. WEIGHT |
8. EYE COLOR |
9. HAIR COLOR |
|
10. PLACE OF BIRTH |
|
|
|
|
11. DOB |
|
||||||||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
PAST DRIVING RECORD |
|
|
|
|
|
|
|
|
|
|||||||||||
|
12. |
STATE OF ISSUE |
|
|
13. LICENSE NUMBER |
|
14. ISSUE DATE |
15. EXP. DATE |
16. CLASS OF VEHICLE |
|
||||||||||||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
17. |
COMMANDING OFFICER'S SIGNATURE |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||
|
|
I RECOMMEND THAT THIS INDIVIDUAL BE EXAMINED FOR |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
|
|
QUALIFICATION TO HOLD THE OF 346 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(Signature) |
|
|
|
(Date) |
|
|||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
PART II EXAMINATION |
|
|
|
|
|
|
|
|
|
|||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||
|
18. |
QUALIFICATION TESTS (CHECK) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||
|
TEST |
|
|
|
SAT |
|
UNSAT |
TEST |
|
|
|
|
|
|
|
SAT |
|
UNSAT |
TEST |
|
|
|
SAT |
UNSAT |
|
|||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
|
PHYSICAL |
|
|
|
|
|
|
|
HEARING |
|
|
|
|
|
|
|
|
|
VISION |
|
|
|
|
|
|
|
||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
|
WRITTEN |
|
|
|
|
|
|
|
REACTION TIME |
|
|
|
|
|
|
|
|
|
SKILL |
|
|
|
|
|
|
|
||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
|
ROAD |
|
|
|
|
|
|
|
DIRT/CROSS COUNTRY |
|
|
|
|
|
|
|
|
|
SPECIAL QUALIFICATION |
|
|
|
|
|
||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||
|
19. RESTRICTIONS: (List) |
|
|
CHECK HERE IF NONE |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
PART III LICENSE ACTION |
|
|
|
|
|
|
|
|
|
|||||||||||
|
20. |
CATEGORY (Check One) |
|
|
|
|
|
|
|
|
|
21. CLASS OF LICENSE (Check all that apply) |
|
|
|
|
|
|||||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||
|
NEW |
RENE |
|
|
|
UPGRADE |
|
DUPLICATE |
COMMERCIAL |
|
|
TACTICAL |
|
|
BUS |
|
TRACTOR |
|
||||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
22.CLASSES OF VEHICLES (Check all that apply)
SEDANS/STATION WAGONS |
|
TRUCKS TO |
|
TON |
|
TRUCKTRACTOR TO |
|
TON |
|
BUSSES TO |
|
PASS |
|
|
|
|
|
|
|
|
|
|
|
|
|
23. SPECIAL QUALIFICATIONS:
SEMITRAILER REFUELER
EMERGENCY VEHICLE
RECOVERY VEHICLE
TRUCK WITH FULL TRAILER
HAZARDOUS MATERIALS
OTHER (SPECIFY)
24. VEHICLE/EQUIPMENT CLASSES QUALIFIED TO OPERATE LIST:
25. SIGNATURE OF LICENSING EXAMINER |
|
|
I CERTIFY THAT THIS INDIVIDUAL IS QUALIFIED TO OPERATE |
|
|
THE ABOVE LISTED EQUIPMENT. |
(Signature) |
(Date) |
|
26. LICENSE # ISSUED
27. DATE ISSUED
28. EXPIRATION DATE
29. SIGNATURE OF LICENSING OFFICER
DATE
PART IV RECORDING ACTION
30. RECORDING OFFICER'S SIGNATURE |
|
I CERTIFY THAT ALL THE INFORMATION IN BLOCKS 19, 20, 23, 24, 26, |
27, |
AND 28 HAVE BEEN ENTERED ON PAGE 11 OF THE INDIVIDUAL'S SRB/OQR |
|
SIGNATURE
DATE
Designed Using FormFlow 2.15, HQMC/ARAE, Apr 98