IW-419 International Driver's License/ID Card Application

Form IW-419

(Rev. June 2012)

Letter J

IDLID Services, Tool free US/Canada: 1-800-608-9594 Other destinations: 1-416-800-8974 idpoffice@

International Driver's License/ID Card Application

? See separate instructions on page 2 and sample on page 3. ? Make a copy for friends. ? Previous editions obsolete.

TYPE OR PRINT YOUR INFORMATION IN THE SPACE PROVIDED BELOW EACH ITEM. PRINT CLEARLY!

Part 1

Identification of Drivers License/ID Card Owner (will be printed on card)

1. Surname (last name)

2. Name (first name)

For Office Use Only

3. Street Address

4. City or Town

5. State or Province (do not abbreviate)

6. Zip or Code Postal

7. Country (do not abbreviate)

8. Date of Birth ( Month - DD - YYYY )

9. Gender (sex)

Male Female

11. Eyes Color

12. Height ( cm or feets )

Gray Green Blue Black Brown Hazel

13. E-Mail

Part 2

Mailing Informatin (to this address your order will be mailed)

14. Surname (last name)

15. Name (first name)

10. Country of Birth (do not abbreviate)

16. Street Address

17. City or Town

18. State or Province (do not abbreviate)

19. Zip or Code Postal

20. Country (do not abbreviate)

21. Home Phone

22. Cell Phone

Part 3

Order Information (payment calculation and options)

A. Select International Drivers License and Options (if require)

IDL Book and Magnetic Stripe Plastic Card +$48 Additional Magnetic Stripe Plastic Card +$15 No Magnetic Stripe Plastic Card (booklet only) -$15

Change Card to Regular (no magnetic strip) -$10 Additional Regular Plastic Card +$10 No Hologram Protection Seal for IDL Book -$10

A 1. IDL Validity Years (1 by Default)

A 2. Driving Categories (For International Driver's License Only)

1 Year 3 Years 5 Years 10 Years A (Motorcicles) B (Regular Cars) C (Trucks) D (Buses) E (Trucks with Trailers)

B. Select Non Governmental ID Card (if require)

Regular Non Governmental ID Card +$23

Add Magnetic Stripe to ID Card +$10

Add Additional ID Card (duplicate) +$15

B 1. ID Card Validity Years (1 by default) B 2. Fill Non Governmental ID Card Type (country or state)(for ID Card only)

1 Year 2 Years 3 Years (do not abbreviate)

C. Select Mailing Option (mandatory)

Regular Registered/Sertified Mail/all destinations available/(2-4 weeks) +$18 Domestic Priority Mail/US or Canada only/(2-3 days) +$26 International Priority Mail/read instruction for available countries/ (7-10 days) +$59 Domestic Express Mail/US or Canada only/(1-2 days) +$43 International Express Mail/read instruction for available countries/ (3-5 days) +$73

Part 3 a

Calculate Total Price

Total from section A $_____ + Total from section B $_____ + Total from section C $_____ = Total For Order to Pay $________

Part 4

Attach Photo Picture, Signature and Native Driver's License Copy

Attach a Copy of Your Native Drivers License Here

(for IDL mandatory, for ID card optionally)

!!DO NOT SEND ORIGINALS!!

Sign in Angle !!DO NOT SIGN OVER LINE!!

Staple or Glue Photo Here

Passport Size from 1.1/4"x1.3/4" and more

from 3x4 cm and more

It will be Printed Digitally

Certification Part 5

1. I declare that I have examined the information on this form and to the best of my knowledge and belief it is true, correct, and complete. 2. I agree that I may not drive, anywhere without a valid original Driver's License, and my International Driver's License is not a standalone document. It must be accompanied by original Driver's License all time of driving. 3. I admit not to use these documents in purpose of breaking or violating the law.

Payment and Mailing (read carefully)

A 1. Please make the application clear. If application is filled with errors or incomprehensibly - reprinting fee will apply.

t 2. You must fill ALL fields.

t 3. Please pay exact amount as calculated in Part 3a. If You pay less amount as required, then product will be corrected to cheapest or application will not be processed till full

e payment received.

n 4. NO DISCOUNTS APPLY FOR PRINTABLE APPLICATION!

t 5. If You mail cash please use registered mail only. ALL PRICES IN US (United States of America) DOLLARS. For conversion rates to other currencies PLEASE EMAIL or CALL us.

i IF TOTAL AMOUNT IS NOT PAID IN FULL DUE TO OUR EXCHANGING RATE THEN ORDER WILL NOT BE PROCESSED.

o n

6. MAKE CHECKS OR MONEY ORDERS PAYABLE TO: O TARASOVA.

Some personal checks might stay on hold up to 30 days till payment is cleared.

Select Convenient Address,

?

O TARASOVA

Cut Proper Address Label, Stick it to Envelope

1750 THE QUEENSWAY., #3-103

and Mail to our Office

ETOBICOKE, ON, M9C5H5

Your Order will be Shipped on Next Business Day Upon Receipt

CANADA

O TARASOVA 793 CENTER STR., # 186 LEWISTON, NY, 14092

USA

Instructions for Form

IW-419

(Rev. June 2012, Letter J)

Application For International Driver's License/ID Card

Purpose of form.

Printable version is provided only for persons who wants to obtain International Driver's License or non-governmental ID Card and has difficulties with completing application online on our web site . By applying online you help us to provide better and faster service. To avoid misreading of handwriting and other mistakes, we kindly ask you to apply online (and you can still mail us your personal information such as driver's license copy and signature sample). Online application has also different options for payments. You can apply online and still mail your checks, money orders, cash, use western union, if that type of payments more convenient for you.

General instructions.

1. To apply for International driver's license you must have valid national driver's license. You must provide a copy of your native driver's license to us for order processing. 2.You must fill Your application clear and legible. If application is filled with errors or incomprehensibly - reprinting fee will apply. 3. You must fill ALL fields. 4. You must carefully select product that you order in Part 3 and calculate total in Part 3a. Pay exact amount as calculated in Part 3a. If You pay less amount as required, then product will be corrected to cheapest or application will not be processed till full payment received. 5. NO DISCOUNTS APPLY FOR PRINTABLE APPLICATION! Pay exact price as printed in application. All discounts available only for online application. Typing fee applied to printable application. 6. If You mail cash please use registered mail only. We are not responsible for non-delivered envelopes. All prices are in US (United States of America) dollars. For conversion rates to other currencies PLEASE EMAIL or CALL us. IF TOTAL AMOUNT IS NOT PAID IN FULL DUE TO OUR EXCHANGING RATE THEN ORDER WILL NOT BE PROCESSED. 7. MAKE CHECKS OR MONEY ORDERS PAYABLE TO: O TARASOVA. Checks with another name on it will not be processed. Some personal checks might stay on hold up to 30 days till payment is cleared.

Definitions.

Part 1. This is personal information that will be printed on Your International Driver's License or ID Card. Fill first and last name only. It can't be too long. If it will be too long - it will be corrected. Height may be filled either centimeters or feet with inches.

Part 2. This is the address where your order will be mailed. Double check this address, otherwise your order will be returned to us. We use traceable mail with signature requirements. So You must provide address where someone stays all the time at home or after receiving notification you must visit postal outlet to pick up your postage. You can check the status of Your shipment on the website of the carrier you have selected. Tracing information will be emailed to you.

Part 3. If You desire to order International Driver's License, You must select in section A "IDL Book and Magnetic Stripe Plastic Card" and select additions or substraction to it. If You order IDL - You must fill Subsection A1 and A2. If You desire to order Non-Governmental ID Card, You must select in section B "Regular Non-Governmental ID Card" and select additions or substraction to it. If You order Non-Governmental ID Card - You must fill Subsection B1 and B2. In section B2 You must print - what kind of Non-Governmental ID Card do You require. This may be "state" or "country" ID only. For special id types like "Press ID" or "Native Americans" please contact us. ATTENTION: we DO NOT make any original documents forgery - do not ask us to forge any native state id, state drivers license, passports or ANY governmental issued documents. All this requests will be ignored.

Part 4. To complete this part you must attach a copy of your native driver's license if You apply for IDL and staple it to proper place. Without this order will not be processed. If You apply for Non-Governmental ID Card - this can be copy of any document. If documents copy will not be provided - your NonGovernmental ID Card will not be online verifiable. You must sign in angle and glue or staple Your photo picture in proper place.

Part 5. You must select best address for mailing from this section, cut mailing label, affix it to envelope by glue or by tape. Make check or money order payable to: O TARASOVA or make a western union payment. Place your application and payment into an envelope and mail it to us. About western union payment information please contact us by E-mail: idpoffice@

Payment information.

1. Dear US customers. Green postal money orders with sign "Negotiable Only In The U.S. And Possessions" will be mailed for clearing. This process may takes up to 45 days. Fos fast processing use international money orders or bank checks.

2. Dear European customers. We has no possibility to process any checks in Euros. You can use bank checks in US(United States) dollars, or cash mailed by registered(certified) letter, or you can send money by western union. If yo has any questions - please contact us.

3. Dear United Kingdom customers. Please do not deface checks by changing pounds to dollars. Defaced checks become invalid and will be destroyed. You can use bank checks in US(United States) dollars, or cash mailed by registered(certified) letter, or you can send money by western union. If yo have any questions - please contact us.

SIW-419 AMPLE IDLID Services, Tool free US/Canada: 1-800-608-9594 Other destinations: 1-416-800-8974 idpoffice@ ForOfficeUseOnly

Form (Rev. June 2012) Letter J

International Driver's License/ID Card Application

? See separate instructions on page 2 and sample on page 3. ? Make a copy for friends. ? Previous editions obsolete.

TYPE OR PRINT YOUR INFORMATION IN THE SPACE PROVIDED BELOW EACH ITEM. PRINT CLEARLY!

Part 1

Identification of Drivers License/ID Card Owner (will be printed on card)

1. Surname (last name)

John

2. Name (first name)

Smith

3. Street Address

11 Main Street Apt 111

4. City or Town

Johnville

5. State or Province (do not abbreviate)

New Jersey

6. Zip or Code Postal

23456

7. Country (do not abbreviate)

United States

8. Date of Birth ( Month - DD - YYYY )

9. Gender (sex)

10. Country of Birth (do not abbreviate)

March 21 1955 x Male Female

Mexico

11. Eyes Color

12. Height ( cm or feets )

Gray xGreen Blue Black Brown Hazel

178 cm

13. E-Mail

myemail@

Part 2

Mailing Informatin (to this address your order will be mailed)

14. Surname (last name)

Sarra

15. Name (first name)

Smith

16. Street Address

149 Rue De Rome apt 23

17. City or Town

Paris

18. State or Province (do not abbreviate)

Paris

19. Zip or Code Postal

75250

20. Country (do not abbreviate)

France

21. Home Phone

+33-075-256-2562

22. Cell Phone

+33-123-234-4567

Part 3

Order Information (payment calculation and options)

A. Select International Drivers License and Options (if require)

x IDL Book and Magnetic Stripe Plastic Card +$48

Change Card to Regular (no magnetic strip) -$10

x Additional Magnetic Stripe Plastic Card +$15 No Magnetic Stripe Plastic Card (booklet only) -$15 Additional Regular Plastic Card x +$10 No Hologram Protection Seal for IDL Book -$10

A 1. IDL Validity Years (1 by Default)

A 2. Driving Categories (For International Driver's License Only)

x1 Year 3 Years 5 Years 10 Years A (Motorcicles) xB (Regular Cars) C (Trucks) D (Buses) E (Trucks with Trailers)

B. Select Non Governmental ID Card (if require)

x Regular Non Governmental ID Card +$23

Add Magnetic Stripe to ID Card +$10

Add Additional ID Card (duplicate) +$15

B 1. ID Card Validity Years (1 by default) B 2. Fill Non Governmental ID Card Type (country or state)(for ID Card only)

x 1 Year 2 Years 3 Years (do not abbreviate) California State

C. Select Mailing Option (mandatory)

x Regular Registered/Certified Mail/all destinations available/(2-4 weeks) +$18

Domestic Priority Mail/US or Canada only/(2-3 days) +$26 International Priority Mail/read instruction for available countries/ (7-10 days) +$59

Domestic Express Mail/US or Canada only/(1-2 days) +$43 International Express Mail (3-5 days) +$73

Part 3 a

Calculate Total Price

Total from section A $__5_3__ + Total from section B $__2_3__ + Total from section C $_1_8___ = Total For Order to Pay $9__4_.0__0_U__S

Part 4

Attach Photo Picture, Signature and Native Driver's License Copy

Sign in Angle !!DO NOT SIGN OVER LINE!!

Sign

Staple or Glue Photo Here

Passport Size from 1.1/4"x1.3/4" and more

from 3x4 cm and more

It will be Printed Digitally

Certification Part 5

1. I declare that I have examined the information on this form and to the best of my knowledge and belief it is true, correct, and complete. 2. I agree that I may not drive, anywhere without a valid original Driver's License, and my International Driver's License is not a standalone document. It must be accompanied by original Driver's License all time of driving. 3. I admit not to use these documents in purpose of breaking or violating the law.

Payment and Mailing (read carefully)

A 1. Please make the application clear. If application is filled with errors or incomprehensibly - reprinting fee will apply.

t 2. You must fill ALL fields.

t 3. Please pay exact amount as calculated in Part 3a. If You pay less amount as required, then product will be corrected to cheapest or application will not be processed till full

e payment received.

n 4. NO DISCOUNTS APPLY FOR PRINTABLE APPLICATION!

t 5. If You mail cash please use registered mail only. ALL PRICES IN US (United States of America) DOLLARS. For conversion rates to other currencies PLEASE EMAIL or CALL us.

i IF TOTAL AMOUNT IS NOT PAID IN FULL DUE TO OUR EXCHANGING RATE THEN ORDER WILL NOT BE PROCESSED.

o n

6. MAKE CHECKS OR MONEY ORDERS PAYABLE TO: O TARASOVA.

Some personal checks might stay on hold up to 30 days till payment is cleared.

Select Convenient Address,

?

Cut Proper Address Label, Stick it to Envelope and Mail to our Office

Your Order will be Shipped on Next Business Day Upon Receipt

I GILKFAOR FASTER PROCESSINI GGILKA 3044 BLOOR STS.EWN.D, #Y4O1U7 R APPL79IC3ACTEINOTNER STR., # 186 TORONTOD, IORNE,RCMT8LXY2YT8O PRINTLINEGWICSETNOTNE, RNY, 14092

CANTAODAOUR CANADIAN ADDRESUSSA

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