Fill Out a Valid DL-43 Form

Fill Out a Valid DL-43 Form

The DL-43 form serves a pivotal role in the updating and managing of driver's license information for residents. As a key document, it facilitates various requests such as name changes, address updates, and the renewal of a driver's license. Despite its significance, the content of the form remains unlisted, highlighting the importance of directly accessing it from relevant authorities.

Open Your Form Now

When navigating the landscape of driving privileges and identification in the United States, one document often emerges as both a pivotal and necessary instrument: the DL-43 form. This essential form serves a multifaceted purpose, enabling individuals to request changes to their driver's license or identification cards. Whether it's a name change, an update in personal details, or correction of existing information, the DL-43 form stands as the gateway to ensuring one's identification aligns accurately with their current status. Its significance extends beyond mere formalities; it touches upon the realms of legal identity, security, and personal verification. In a world where identification is key to accessing a myriad of services and rights, the precision and relevance of the information contained within one's ID cannot be overstated. Through the completion and submission of this form, individuals engage directly with the infrastructure designed to safeguard their identity, highlighting the form's critical role in maintaining the integrity of personal records.

Document Example

 

APPLICATION FOR RENEWAL/REPLACEMENT/CHANGE

 

 

 

 

 

 

(Replacement also called Duplicate)

 

 

 

 

OF A TEXAS DRIVER LICENSE OR IDENTIFICATION CARD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DL or ID NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

APPLICANT INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CONTACT INFORMATION

 

 

 

 

 

 

 

LAST NAME:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOME PHONE:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FIRST NAME:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OTHER PHONE:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MIDDLE NAME:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EMAIL:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SUFFIX:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ADDRESS INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MAIDEN NAME:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RESIDENCE ADDRESS:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE OF BIRTH (mm/dd/yyyy):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CITY:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STATE:

 

 

 

 

 

SSN:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ZIP CODE:

 

 

 

 

 

 

 

 

COUNTY:

 

 

 

 

 

 

 

 

 

SEX: (Mark One)

 

MALE

 

FEMALE

 

 

WEIGHT: lbs.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MAILING ADDRESS:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EYE COLOR:

 

 

 

 

 

 

 

 

 

 

 

 

 

HEIGHT: ft.

 

 

 

 

 

 

in.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RACE/ETHNICITY:

 

 

 

 

 

 

 

(I)

American Indian/Alaska

Native

 

 

CITY:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STATE:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(A) Asian/Pacific Islander

(B) Black (H) Hispanic (O) Other

(W) White

ZIP CODE:

 

 

 

 

 

 

 

 

COUNTY:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INFORMATION FORM (ALL APPLICANTS please answer questions 1 through 10)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1. YES NO

 

Are you a citizen of the United States?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

 

 

 

 

 

If you are a US citizen, would you like to register to vote? If registered, would you like to update your voter information?

 

 

 

 

 

 

 

 

 

By providing my electronic signature, I understand the personal information on my application form and my electronic signature will be used for submitting

 

 

 

 

 

 

my voter’s registration application to the Texas Secretary of State’s office. Wanting to register to vote, I authorize the Department of Public Safety to

3.

 

 

 

 

 

transfer this information to the Texas Secretary of State.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Do you wish to donate $1.00 to the Blindness Education Screening and Treatment Program?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4.

 

 

 

 

 

Do you want to support the Glenda Dawson Donate Life Texas donor registry? If yes, please indicate a donation amount of $1 or more $

 

.00

5.

 

 

 

 

 

Would you like to register as an organ donor?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6.

 

 

 

 

 

Do you want to support survivors of sexual assault? If yes, please indicate a donation amount of $1 or more $

 

 

 

.00 to help fund the testing

 

 

 

7.

 

 

 

 

 

of sexual assault evidence collection kits (rape kits).

 

 

 

 

 

 

 

 

 

.00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Do you want to support Texas Veterans?

If yes, please indicate your donation amount $

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8.

 

 

 

 

 

Do you have a health condition that may impede communication with a peace officer? If yes, please list

 

 

 

 

 

 

 

9.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(physician must complete form DL-101 prior to the issuance of a DL/ID).

 

 

 

 

 

a) Do you want a Veteran designator on your driver license or identification card?

(proof of Honorable discharge required; acceptable documents

 

 

 

 

 

 

b)

are DD214/5, NGB22, VA disability letter, proof of service/verification of honorable service card)

 

 

 

 

 

 

 

10.

 

 

 

 

 

Are you a 60% disabled Veteran receiving compensation and want to waive the application fee? (see 9a for documents required)

 

 

 

 

 

 

 

 

In the event of injury or death would you like to provide two (2) emergency contacts? If yes, please list:

 

 

 

 

 

 

 

 

 

 

 

 

 

a)

Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Telephone Number

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

b)

Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Telephone Number

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

For all Driver License Renewals complete MEDICAL questions 11 to 17. Answers to the questions below are for the confidential use of the Department.

 

 

 

11.

 

 

 

 

 

Do you currently have or have you ever been diagnosed with or treated for any medical condition that may affect your ability to safely operate a

 

 

 

 

 

 

 

 

 

motor vehicle?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Examples, including but not limited to: Diagnosis or treatment for heart trouble, stroke, hemorrhage or clots, high blood pressure, emphysema (within past two years)

 progressive eye disorder or injury (i.e., glaucoma, macular degeneration, etc.)  loss of normal use of hand, arm, foot or leg  blackouts, seizures, loss of consciousness

or body control (within the past two years) 

difficulty turning head from side to side

 loss of muscular control  stiff joints or neck  inadequate hand/eye

coordination  medical condition that affects your judgment  dizziness or balance problems

 missing limbs

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If you answered YES above, has your condition

IMPROVED or

DETERIORATED since your last application for an original/renewal remake of your driver license?

12.

 

 

 

 

 

Do you have a mental condition that may affect your ability to safely operate a motor vehicle?

If yes, please explain:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Have you ever had an epileptic seizure, convulsion, loss of consciousness, or other seizure?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14.

 

 

 

 

Do you have diabetes requiring treatment by insulin?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

15.

 

 

 

 

Do you have any alcohol or drug dependencies that may affect your ability to safely operate a motor vehicle or have you had any episodes

 

 

 

16.

 

 

 

 

of alcohol or drug abuse within the past two years?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Within the past two years, have you been treated for any other serious medical conditions?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

17.

 

 

 

 

Explain:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Have you EVER been referred to the Texas Medical Advisory Board for Driver Licensing?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Any male United States citizen or immigrant who is at least 18 years of age but less than 26 years of age submitting this application consents to registration with the

United States Selective Service System. You must be registered to qualify for federal student aid (to include Pell grant), job training, federal employment, and citizenship

if an immigrant. In Texas, you must be registered to qualify for state college student aid or state employment. If convicted, failure to register with the Selective Service is

a felony punishable by up to five years in prison and/or a $250,000 fine. If not registered by age 26, you can no longer register and could permanently lose those benefits

associated with registration. For alternative options for applicants who object to conventional military service for religious or other conscientious reasons information is

available at: http://www.sss.gov/FactSheets/FSaltsvc.pdf.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I do solemnly swear, affirm, or certify that I am the person named herein and that the statements on this information form are true and correct. I further certify my resi-

dence address is a (check one): (

) single family dwelling, (

 

) apartment, ( ) motel, (

) temporary shelter. I agree to immediately report to the Texas Department of

Public Safety any changes in my medical condition which may affect my ability to safely operate a motor vehicle.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DL-43 (Rev. 1/18)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE OF APPLICANT

 

 

 

 

 

 

 

 

 

 

DATE

 

 

 

 

SOLICITUD PARA RENOVAR, REEMPLAZAR, Ó HACER

 

(El reemplazo también es llamado duplicado)

 

CAMBIOS EN LA LICENCIA DE CONDUCIR O TARJETA DE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NUMERO DE LICENCIA O DE TARJETA DE IDENTIFICACIÓN:

 

 

 

 

IDENTIFICACIÓN DEL ESTADO DE TEXAS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INFORMACIÓN DEL SOLICITANTE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INFORMACIÓN DE CONTACTO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

APELLIDO:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NÚMERO DE TELÉFONO:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PRIMER NOMBRE:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TELÉFONO SECUNDARIO:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SEGUNDO NOMBRE:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CORREO ELECTRÓNICO:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SUFIJO:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SU DOMICILIO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

APELLIDO DE SOLTERA:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DOMICILIO DONDE RESIDE:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FECHA DE NACIMIENTO (mm/dd/aaaa):

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CIUDAD:

 

 

 

 

 

 

 

 

 

 

 

 

 

ESTADO:

 

 

 

 

 

NÚMERO DE SEGURO SOCIAL:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CÓDIGO POSTAL:

 

 

 

 

CONDADO:

 

 

 

 

 

 

SEXO: (Marque uno)

HOMBRE

MUJER

PESO: en libres.

 

 

 

 

 

 

DOMICILIO POSTAL (Lugar donde recibe su correspondencia):

 

 

 

 

COLOR DE LOS OJOS:

 

 

 

 

 

 

 

 

ESTATURA: pies

 

 

 

 

pulg.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RAZA/ETNIA:

 

 

 

(I) Amerindio/Nativo de Alaska

(A) Asiático/nativo

 

 

 

CIUDAD:

 

 

 

 

 

 

 

 

 

 

 

ESTADO:

 

 

 

 

 

de las Islas del Pacífico (B) Negro (H) Hispano (O) Otro (W) Blanco

 

 

 

 

 

 

CÓDIGO POSTAL:

 

 

 

 

CONDADO:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INFORMACIÓN SOBRE EL SOLICITANTE (TODOS LOS SOLICITANTES favor de contestar las preguntas 1 a 10)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1.

SI NO

¿Es usted ciudadano de los Estados Unidos?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2.

 

 

 

Si usted es ciudadano de los Estados Unidos, ¿le gustaría registrarse para votar? Si ya está registrado, ¿le gustaría actualizar su información de votante?

 

 

 

 

Al proporcionar mi firma electrónica, comprendo que la información personal en mi solicitud, junto con mi firma electrónica, se usará para enviar mi

 

 

 

 

solicitud de registro electoral a la oficina de la Secretaría del Estado de Texas. Deseo registrarme para votar; por lo tanto, autorizo al Departamento

3.

 

 

 

de Seguridad Pública para transferir esta información a la Secretaría del Estado de Texas.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

¿Desea usted donar $1.00 al Programa de Educación, Evaluación y Tratamiento de la Ceguera?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4.

 

 

 

¿Desea apoyar el Programa de Registro de Texas-Glenda Dawson Donar Vida? En caso afirmativo, indicar una cantidad de la donación

5.

 

 

 

de $1 o más $

.00

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

¿Desea registrarse como donador de órganos?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6.

 

 

 

¿Quieres apoyar a los sobrevivientes de asalto sexual? Si es así, porfavor indique la cantidad de donación de $1 o más $

 

 

.00 para

7.

 

 

 

ayudar a financiar la recopilación de evidencia de asalto sexual (kit de violación)

 

 

 

 

 

 

.00

 

 

 

 

 

 

 

 

 

 

¿Desea apoyar los Veteranos de Texas? Si la respuesta es sí, por favor, indique la cantidad de su donación $

 

 

 

 

 

 

 

8.

 

 

 

¿Tiene usted alguna afección médica que le pueda impedir la comunicación con un oficial de la policía? En caso afirmativo, por favor indique

9.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(el médico debe llenar el formulario DL-101 antes de emitir una licencia de conducir o tarjeta de identificación).

 

 

 

a) Desea una insignia de Veterano en su licencia de conducir o su tarjeta de identificación? (Se requiere comprobante de baja honorable; los

 

 

 

 

b)

documentos aceptables son DD214/5, NGB22, carta de discapacidad del VA, prueba de servicio/verificación de la tarjeta de servicio honorable)

 

 

 

 

¿Es usted un Veterano que recibe 60% de compensación por discapacidad y desea quedar exento de los derechos de solicitud?

10.

 

 

 

 

(vea el punto 9a para conocer qué documentos se requieren).

 

 

 

 

 

 

 

 

En caso afirmativo, por favor indique:

 

 

 

En caso de sufrir lesiones o la muerte, ¿le gustaría proporcionar dos (2) contactos para emergencias?

 

 

 

 

a)

Nombre

 

 

 

 

 

 

 

 

 

 

 

 

 

Número telefónico

 

 

 

 

 

 

 

 

 

Domicilio

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

b)

Nombre

 

 

 

 

 

 

 

 

 

 

 

 

 

Número telefónico

 

 

 

 

 

 

 

 

 

Domicilio

 

 

 

 

 

 

 

 

 

 

 

 

Para todas las Renovaciones de Licencia de Conducir, complete las preguntas MÉDICAS 11 a 17.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Las respuestas a las siguientes preguntas son para uso confidencial del Departamento.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11.

 

 

 

¿Tiene actualmente o alguna vez ha sido diagnosticado con o tratado por alguna enfermedad que pueda afectar su capacidad de

 

 

 

 

operar un vehículo motorizado de manera segura?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ejemplos, incluyendo pero no limitado a: Diagnóstico o tratamiento por problemas cardíacos, derrame cerebral, hemorragia o coágulos, presión arterial alta, enfisema (en los últi-

mos dos años)  enfermedad progresiva o lesión de la vista (como glaucoma, degeneración macular, etc.)  pérdida del uso normal de la mano, brazo, pie o pierna  desvanec-

imientos, ataques, pérdida de la consciencia o control del cuerpo (en los últimos dos años)

 dificultad para voltear la cabeza de un lado a otro

 pérdida de control muscular  artic-

ulaciones o cuello rígidos  coordinación inadecuada de mano/ojo  afección médica que altere su juicio  mareos o problemas de equilibrio  pérdida de algún miembro

Si respondió a la pregunta anterior, ¿su afección ha

MEJORADO o

EMPEORADO desde su última solicitud de original/renovación de licencia de conducir?

12.

 

 

 

¿Tiene usted un condición mental que puede afectar su capacidad para operar con seguridad un vehículo motorizado? Si su respuesta es si,

13.

 

 

 

por favor de explicar:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

¿Alguna vez ha tenido un ataque epiléptico, convulsión, pérdida de la consciencia u otro ataque?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14.

 

 

 

¿Tiene diabetes que requiera tratamiento con insulina?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

15.

 

 

 

¿Tiene alguna dependencia del alcohol o de drogas que pudiera afectar su capacidad de operar un vehículo motorizado de manera

16.

 

 

 

segura o ha tenido algún episodio de abuso de drogas o alcohol en los últimos dos años?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

En los últimos dos años, ¿ha recibido tratamiento por alguna otra afección médica grave?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

17.

 

 

 

Explique:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

¿Alguna vez ha sido remitido al Comité Asesor Médico de Licencias de Conducir de Texas?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Cualquier hombre ciudadano o inmigrante de los Estados Unidos entre 18 y 26 años de edad que presente esta solicitud otorga su consentimiento para ser registrado

en el Sistema de Servicio Militar Selectivo de los Estados Unidos. Usted debe estar registrado para tener derecho a recibir ayuda federal estudiantil (incluso la beca

Pell Grant), capacitación laboral, empleo federal y la ciudadanía si es inmigrante,. En Texas, usted debe estar registrado para tener derecho a recibir ayuda estudiantil

universitaria o empleo con el Estado. No registrarse en el Servicio Militar Selectivo es un delito mayor. Si es declarado culpable de ello, podría ser castigado hasta con

cinco años de prisión y/o una multa de 250,000 dólares. Si no se ha registrado antes de cumplir 26 años, ya no se podrá registrar y podría perder permanentemente los

beneficios asociados con el registro. Para conocer otras opciones alternativas para solicitantes que se oponen al servicio militar convencional por motivos religiosos u otros

motivos de conciencia, podrá encontrar información disponible en: http://www.sss.gov/FactSheets/FSaltsvc.pdf.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Juro solemnemente, afirmo o certifico que soy la persona que se indica en el presente documento y que las declaraciones en esta solicitud son verdaderas y correctas. Además

certifico que mi domicilio de residencia es (marque una opción): (

) casa residencial, (

 

) apartamento, ( ) hotel, ( ) sitio de refugio temporal. Estoy de acuerdo en informar

inmediatamente al Departamento de Seguridad Pública de Texas cualquier cambio en mi condición médica que pueda afectar mi capacidad para conducir de manera segura

un vehículo motorizado.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DL-43 (Rev. 1/18)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FIRMA DEL ASPIRANTE

 

 

 

 

 

 

 

 

 

 

 

 

 

FECHA

 

 

 

 

Form Breakdown

Fact Number Description
1 The DL-43 form is used for requesting changes to a driver's license or identification card in the issuing state.
2 This form can be used to update personal information, such as name or address changes.
3 Applicants may also use it to apply for a duplicate license or ID card if the original is lost, stolen, or damaged.
4 The form requires various personal details, including the applicant's full name, date of birth, and Social Security number.
5 Depending on the state, additional documentation may be required to support the changes requested on the DL-43 form.
6 Submission methods vary, with some states allowing online submission, while others may require mailing or in-person delivery to a designated office.
7 Governing laws differ by state but typically involve transportation or motor vehicle department regulations.

DL-43 - Usage Guide

When you’re facing the task of updating or making changes to your driver's license or identification card, you'll find yourself in need of the DL-43 form. This might include changes such as updating your address, applying for a duplicate license, or changing your name. Understanding how to properly fill out this form is the first step in the process. Although the form itself may not be described in detail here, the following steps provide a general guide to complete similar forms accurately.

  1. Start by carefully reading through the entire form to ensure you understand all the requirements and sections. Pay close attention to any instructions or guidelines provided at the beginning of the form.
  2. Fill in your personal information, including your full name (both current and new if you are making a name change), date of birth, and the identification number from your driver's license or ID card.
  3. Proceed to indicate the type of application you're making. This could be for a duplicate license, a change of address, or a name change. Ensure you check the appropriate box or fill in the necessary space to indicate your purpose.
  4. Provide your contact information. This section usually requires your current address, telephone number, and sometimes an email address. Make sure the information is accurate and up-to-date.
  5. For changes in personal information such as your address or name, provide the required details or documents. If the form specifies the need for additional documentation (like a marriage certificate for a name change), be sure to attach the required papers.
  6. Review the declaration or oath section carefully, if present. Signing this part of the form typically attests that the information you've provided is accurate to the best of your knowledge and that you understand the terms and conditions.
  7. Complete the form by signing and dating it in the designated area. Your signature is crucial as it validates the form.
  8. Follow any specific instructions provided for submitting the form, which could include mailing it to a specific address, taking it to a local office in person, or possibly submitting it online if the option is available.

Upon completing and submitting the DL-43 form or its equivalent based on your specific needs, the issuing agency will process your application. Processing times vary, so it’s wise to allow ample time before you need your updated license or ID. Once processed, you will receive your new or updated document either by mail or by picking it up, depending on the agency's practices. Throughout this process, be prepared to show proof of identity and possibly other documentation, making sure all is in order for a smooth transition.

More About DL-43

What is a DL-43 form and when is it required?

The DL-43 form, commonly known as the Application for Texas Driver License or Identification Card Renewal and Change of Address, is required when individuals need to renew or update their Texas driver's license or identification card. This form is utilized for various purposes including renewing an expiring or expired license, changing the address on a current license, or updating personal information such as your name or gender. It serves as a critical component in ensuring your driver’s license or ID card reflects accurate and current information.

How can one obtain a DL-43 form?

Individuals can obtain the DL-43 form in several convenient ways. The Texas Department of Public Safety (DPS) offers this form online, allowing it to be downloaded and printed from the comfort of your home. Alternatively, one can visit any local DPS office to pick up a physical copy of the form. For those who prefer receiving the form by mail, a request can be made to the DPS by contacting them directly through their customer service line or by sending a written request through postal mail to the DPS headquarters.

Are there any fees associated with the DL-43 form?

While obtaining and completing the DL-43 form itself is free of charge, there are fees associated with the renewal or update of a Texas driver license or identification card. These fees vary depending on the type of license, the age of the applicant, and the length of validity of the license being issued. Specific fee information can be found on the Texas Department of Public Safety’s official website or by inquiring directly at a DPS office. It is important for individuals to prepare for these fees ahead of their visit to ensure a smooth and efficient processing experience.

What documents are required to be submitted with the DL-43 form?

When submitting a DL-43 form, several documents are required to verify identity, residency, and eligibility. Generally, you will need to provide proof of identity (such as a birth certificate or passport), proof of Social Security Number, proof of U.S. citizenship or lawful presence (for non-citizens), and proof of Texas residency. For those changing their name, legal documentation reflecting the name change (such as a marriage certificate or court order) must also be included. The exact documents required may vary based on individual circumstances, so it is recommended to check the Texas DPS website for a comprehensive list and to ensure compliance with all requirements.

Common mistakes

Filling out official documents requires a meticulous approach, and the DL-43 form is no exception. A common error occurs when individuals, in a rush, skip reading the instructions thoroughly. These instructions are designed to guide the applicant through each section, ensuring that the information provided is accurate and complete. By overlooking this crucial first step, applicants increase the likelihood of making further mistakes, leading to possible delays or even the rejection of their application.

Another frequent mistake involves incorrect personal information. At times, applicants may inadvertently transpose numbers in their social security number or provide a previous address instead of their current one. Such inaccuracies, though seemingly minor, can lead to significant complications in the processing of the form. Authorities rely on this information to verify the applicant's identity, and discrepancies can raise flags, necessitating additional steps to confirm the applicant's identity.

Furthermore, signatures and dates often present another area where errors are made. Many applicants forget to sign the form or date it, which is a critical oversight. This simple act of omission can invalidate the entire application, as a signature is a legally binding acknowledgment of the information provided. Additionally, when the date of signing is incorrect or missing, it can create confusion regarding the relevance and timeliness of the information submitted.

Photograph specifications can also be a source of error for many. The DL-43 form requires a photograph that meets certain criteria, which can include size, background color, and the position of the applicant within the frame. Applicants who neglect these specifications and submit an unsuitable photo may face delays. The importance of the photo adhering to specified guidelines cannot be overstated, as it is a key component of the identity verification process.

Last but not least, overlooking the fee details can create unnecessary obstacles. It is essential for applicants to verify the correct amount and form of payment accepted for the processing of the DL-43 form. A common oversight is assuming the fee amount without consulting the most current information or attempting to pay with a method that is not accepted. This misstep can lead to the return of the application, requiring the applicant to correct the error and resubmit the form, further delaying the process.

Documents used along the form

Handling legal documents can often feel like navigating through a labyrinth; getting your driver's license or updating it is no different. It goes beyond just filling out the DL-43 form for driver's license renewals or amendments. This essential form is usually accompanied by a set of other documents, each serving its unique purpose in the process. Understanding these documents is pivotal for a smooth journey through bureaucratic procedures. Let's delve into a list of documents that are frequently used alongside the DL-43 form, providing you a roadmap to what you might need in your venture.

  • Proof of Identity: This could be a birth certificate, passport, or state-issued ID card. It’s used to verify the identity of the person applying for the license or requesting changes.
  • Social Security Card: A requirement in many states, it's used to verify the applicant's social security number for identification and record-keeping purposes.
  • Proof of Legal Presence: For non-citizens, documents like a permanent resident card or a valid visa help verify that the applicant has legal permission to reside in the country.
  • Proof of Residency: Utility bills, lease agreements, or mortgage statements can be used to prove that the applicant lives at a certain address within the state.
  • Application for License: While the DL-43 form is for renewals or amendments, a separate application form is required for first-time applicants or those applying for a commercial or motorcycle license.
  • Vehicle Registration Documents: If you're applying for a license that involves a road test, you'll need to provide evidence that the vehicle you're using is registered in your name or that you have permission to use it.
  • Proof of Insurance: Again, for road testing, showing that the vehicle is insured is essential. This ensures that both the applicant and the DMV are covered in case of an accident.
  • Medical Examination Report: For commercial driver's license applicants, a medical examination report is required to ensure the applicant is physically capable of operating a commercial vehicle safely.
  • Driving Record Abstract: Some situations may require an applicant to submit their driving record, especially if applying for a license in a new state or when specific endorsements are involved.
  • Passport Photos: While not always required, some states may ask for passport-sized photos, especially for new applicants or when updating photo information on the licensure.

Every document plays a crucial role in the tapestry of legal requirements for driver’s licensing. Whether you are applying for the first time, renewing, or amending your license, it's essential to check with your local Department of Motor Vehicles (DMV) for the most current list of required documents. States may have their own specific requirements, and staying informed will ensure you are always one step ahead in your legal journey. Remember, the goal is to ensure that all drivers meet the criteria to drive safely and legally, protecting not just themselves but everyone on the road.

Similar forms

The DL-43 form, often used for various driver's license transactions such as renewals or updates, shares similarities with the SS-5 Form used for Social Security card applications. Both forms are essential for updating personal information with government agencies and require detailed personal identification data. They guide users through providing their full name, address, and identification details. Like the DL-43, completing the SS-5 is a critical step for citizens needing to update their official identification documents.

Similar to the DL-43 form, the Passport Application Form (DS-11) is another document critical for identity verification and personal information update. Individuals looking to apply for, renew, or update their passport must complete the DS-11, which, like the DL-43, gathers comprehensive personal information, including birth details, address, and parental information. Both forms are pivotal in maintaining up-to-date personal identification that's recognized nationally and, for the passport, internationally.

The Voter Registration Form is another document whose purpose and requirements resonate with the DL-43 form. It facilitates a critical civic process, similar to how the DL-43 enables legal driving privileges. Both forms collect personal identification to ensure the applicant’s eligibility for the service they’re applying for—driving in the case of the DL-43 and voting for the Voter Registration Form. These forms are essential for participation in societal duties and privileges.

The Application for Employment Authorization (Form I-765) is used by non-citizens to request permission to work in the U.S. It parallels the DL-43 form in structure and intent, with both requiring detailed personal information and legal status for the purpose of granting rights or privileges within the United States. The I-765 is an important step for immigrants to legally engage in employment, akin to how the DL-43 is necessary for individuals to obtain or renew their driver's license.

Lastly, the Car Registration Form, required for registering a new or used vehicle, resembles the DL-43 form in its function of updating and validating personal and legal information within state databases. Both forms are integral to legal compliance and personal accountability in state records, focusing on vehicular operation and ownership for the Car Registration Form, and driving qualifications for the DL-43. This ensures that individuals are properly registered and authorized for their respective responsibilities.

Dos and Don'ts

When filling out the DL-43 form, which is used for driver's license or identification card renewals and changes in Texas, it's important to follow these guidelines to ensure a smooth process. Below is a list of dos and don'ts that can help:

  • Do double-check that all your personal information is current and correct. This includes your address, name (if it has changed due to marriage or other reasons), and any other details requested on the form.
  • Do use black or blue ink if the form is to be filled out by hand. This ensures the form is readable when scanned or photocopied.
  • Do read each question carefully to ensure you understand what is being asked before answering. Misinterpretations can lead to errors that might delay the process.
  • Do sign and date the form in the designated areas. Your application might not be processed without your signature.
  • Do keep a copy of the form for your records before submitting it. This will help you have a reference in case there are any questions or issues.
  • Don't leave required fields blank. Incomplete forms are typically rejected or returned, causing delays.
  • Don't use correction fluid or tape. Mistakes should be neatly crossed out, and the correct information should be clearly written nearby.
  • Don't guess on any information. If you're unsure about something, it's better to verify the correct information before filling it out on the form.
  • Don't fold, staple, or otherwise damage the form when submitting it. This can cause complications with processing and might lead to delays.

Misconceptions

The DL-43 form, often surrounded by misconceptions, plays a critical role in driver's license applications and renewals. This document aims to clarify some common misunderstandings.

  • It's only for new drivers. Contrary to this belief, the DL-43 form is not exclusively for new drivers. It's also used by existing drivers to renew, update information, or request a duplicate license.

  • The form can be submitted online by everyone. While online services are available, not every applicant can submit the DL-43 form online. Requirements vary by state, and certain individuals may need to submit their form in person or via mail.

  • No personal documentation is needed when submitting the DL-43 form. This is misleading. Depending on the purpose of the submission, various forms of personal identification and documentation, like proof of residence or Social Security number, may be required.

  • Once submitted, no further action is required. Often, submission of the DL-43 form is just the first step. Applicants may need to complete additional steps, such as passing a vision or driving test, before their request is fully processed.

  • The DL-43 form is the same in every state. This assumption is incorrect. While the DL-43 form serves similar functions across the U.S., its format, requirements, and processing can vary significantly from one state to another.

  • There's no deadline for submitting the DL-43 form. Deadlines are indeed a factor. Depending on the context, such as a license renewal, there are specific time frames within which the DL-43 form must be submitted to avoid penalties or expiration.

  • If you make a mistake on the form, you have to start all over again. Mistakes can typically be corrected without starting from scratch. Contacting the relevant department directly for guidance on how to amend errors is the recommended approach.

  • The information on your current license doesn't need to match what's on the DL-43 form. In fact, the information provided on the DL-43 form should match your current identification details. Discrepancies can lead to delays or rejection of your application.

Clearing up these misconceptions is vital for ensuring a smooth process, whether you're applying for your first license or renewing an existing one. Always confirm with your local DMV or appropriate issuing authority for the most accurate and up-to-date information related to the DL-43 form and its requirements.

Key takeaways

The DL-43 form is used for various purposes, including updating personal information or applying for a replacement of a Texas driver's license or identification card. Below are key takeaways to ensure a smooth process when filling out and using the DL-43 form.

  • Complete all sections accurately: It's essential to provide true and accurate information in every part of the form to prevent delays or issues.
  • Proof of identity is required: When submitting the DL-43 form, you must also provide acceptable proof of identity. Check the Texas Department of Public Safety website for a list of approved documents.
  • Notarization may be required: Depending on the specific use of the form, some sections might need to be notarized. Ensure to check these requirements before submission.
  • Renewal notice: If using the DL-43 form for license renewal, attach any renewal notice you received, if applicable, to speed up the process.
  • Report changes promptly: For changes in personal information such as an address change, it's important to file the DL-43 form promptly to ensure records are up-to-date.
  • Replacement for lost or stolen ID: Use the DL-43 form if your license or identification card has been lost or stolen, but make sure to also report the loss or theft to local law enforcement.
  • Fees: Check the current fee schedule associated with the DL-43 form submission, as fees may vary depending on the type of service requested.
  • Mailing instructions: Follow the specific mailing instructions provided within the form or by the Texas Department of Public Safety to ensure your form is processed efficiently.

By following these guidelines, you can expect a smoother process in updating your information or acquiring a replacement for your driver's license or identification card through the DL-43 form.

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