Homepage Free DL-43 PDF Template
Outline

The DL-43 form plays a crucial role for individuals seeking to make official changes to their driver’s license or identification card in several jurisdictions. This form is utilized for a variety of modifications including updates to personal information such as a change in name, address, or gender marker. Additionally, it serves as a request form for the replacement of a lost or stolen license, making it an essential document for maintaining the validity and accuracy of one’s identification. The process for submitting a DL-43 form is straightforward, requiring individuals to fill out their current details alongside the changes they wish to make. It is important for users to provide accurate information and, in some cases, supporting documents may be required to process the request effectively. The DL-43 form embodies the administrative process’s commitment to ensuring that identification documents remain current and reflective of the holder's accurate personal information.

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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

 

 

 

 

Document Attributes

Fact Name Description
Purpose of the DL-43 Form Used for a range of driver licensing services including renewal, replacement, or change of address on a driver's license.
State-Specific Application Relevant to the Texas Department of Public Safety, indicating its use is governed by Texas state law.
Accessibility Available online through the Texas Department of Public Safety's website, enabling easy access and submission.
Requirements for Submission Must be completed by individuals who wish to update their driver's license details; requires personal identification information.
Governing Law(s) Governed under the Texas Transportation Code, which provides the legal framework for the issuance and management of driver's licenses in Texas.

How to Fill Out DL-43

Once the DL-43 form is received, individuals are on a path to addressing changes related to their driver's license or identification card. This process may involve updating personal information, such as a name or address change, or could also be used to request a duplicate or additional copy of these important documents. Completing the form accurately is crucial for ensuring that these requests are processed without delay. The following steps are designed to guide through this process efficiently.

  1. Locate the form number (DL-43) at the top of the document to confirm you have the correct form.
  2. Begin by entering your full legal name, including first, middle, last, and any suffix, ensuring it matches the name on your current driver's license or identification card.
  3. Fill out your date of birth in the format MM/DD/YYYY.
  4. Next, provide your Social Security Number in the designated field. Ensure accuracy as this information is critical for identification purposes.
  5. Specify your gender by checking the appropriate box.
  6. Enter your current mailing address, including street number and name, city, state, and ZIP code, to ensure you receive all correspondence without any issues.
  7. If your residence address differs from your mailing address, provide the details in the space given.
  8. Choose the type of application you are submitting (e.g., change of address, name change, request for duplicate) by checking the corresponding box.
  9. If applicable, fill in the details regarding your name change, including the new name and supporting documentation reference number.
  10. Sign and date the form in the designated areas to certify that all the information provided is accurate and truthful.
  11. Review the entire form for any errors or omissions, making any necessary corrections before submission.
  12. Follow the instructions provided for submitting the form, which may include mailing it to a specified address or delivering it in person to a designated office.

After the form has been submitted correctly, it will be processed by the relevant department. The individual will then receive a confirmation, followed by the new or updated driver's license or identification card, according to the request made. It is important to ensure that all provided information is accurate and matches any legal documentation to avoid any delays in this process.

More About DL-43

  1. What is the DL-43 form used for?

    The DL-43 form is a document utilized by individuals seeking to update their personal information on their driver's license or identification card. This might include changes in name, address, or gender identity. Additionally, it can be used for requesting a replacement for a lost or damaged card.

  2. Who needs to fill out the DL-43 form?

    Any resident needing to officially update their driver's license or identification card with the state motor vehicle department is required to complete the DL-43 form. It’s particularly relevant for those who have undergone a legal name change, moved to a new address, or wish to correct or update personal details on their existing ID or driver's license.

  3. Where can I obtain a DL-43 form?

    The DL-43 form is available through the official website of the state's motor vehicle department. In addition, individuals can visit a local office to pick up a copy in person. Some states may also offer the option to request the form by mail or phone call.

  4. What information is needed to complete the DL-43 form?

    When filling out the DL-43 form, you will be asked to provide personal details such as your full legal name, date of birth, social security number, and current address. Depending on the nature of your request, you may also need to provide supporting documentation, like a marriage certificate for a name change or a court order for a gender marker change.

  5. How do I submit the DL-43 form once it is filled out?

    Upon completing the form, individuals can choose to submit it through various methods, depending on the state's procedures. Commonly, forms can be mailed to the specified address of the motor vehicle department, submitted in person at a local office, or, in some instances, submitted online through the state’s official website.

  6. Is there a fee associated with the DL-43 form submission?

    Yes, submitting a DL-43 form usually requires a processing fee. This fee varies by state and the specific transaction being requested, such as a name change or a replacement ID. It's important to verify the exact fee and accepted payment methods with the state's motor vehicle department beforehand to ensure correct payment.

Common mistakes

Filling out the DL-43 form, an application for Texas driver's license renewal or change, often seems straightforward. However, errors can occur, potentially leading to delays or issues in processing. Acknowledging these mistakes upfront can enhance accuracy and streamline the application process.

  1. Not verifying personal information: Applicants frequently overlook the importance of double-checking their personal details, such as the spelling of their name, date of birth, and social security number. This can lead to mismatches in official records.

  2. Ignoring the need for supporting documents: The submission often accompanies a requirement for additional documentation, such as proof of identity or residency. Failure to attach these documents can result in an incomplete application.

  3. Leaving sections blank: Some sections may seem irrelevant to the applicant but are mandatory for submission. Skipping these sections can lead to the form being returned for completion.

  4. Using incorrect payment methods: The form specifies acceptable forms of payment for the renewal or change fee. Using an unauthorized payment method can delay processing.

  5. Failing to update changes in address or name: Applicants who have recently moved or changed their name legally may forget to update this information on the DL-43 form, leading to discrepancies and potential legal issues.

  6. Not signing the form: An unsigned form is considered incomplete. The application process cannot proceed without the applicant's signature, which officially confirms the accuracy of the information provided.

Recognizing and avoiding these mistakes can facilitate a smoother renewal or change process, ensuring the timely issuance of the driver's license.

Documents used along the form

When updating, renewing, or obtaining a driver's license, various forms and documents may be required alongside the DL-43 form. Understanding these documents ensures a smoother process. Each serves a specific purpose and may be needed depending on your situation.

  • Proof of Identification - This can include a birth certificate, passport, or other government-issued ID. It's used to verify your identity when submitting the DL-43.
  • Social Security Card - A Social Security card or document verifying your Social Security number ensures that your driving records and other legal documents are accurately associated with your identity.
  • Proof of Residency - You may need utility bills, lease agreements, or mortgage statements that confirm your current address. This is crucial for verifying that you reside within the jurisdiction issuing the license.
  • Vision Test Certification - Some states require you to submit proof of a recent vision test when renewing or obtaining a new driver's license. This document confirms your visual acuity meets the required standards for driving.

Collecting these documents before starting your application or renewal process with the DL-43 form can save time and reduce the need for multiple visits to the DMV or other processing centers. Always check the specific requirements of your state or issuing authority, as they can vary significantly. Be prepared and organized to facilitate a more efficient and less stressful experience.

Similar forms

  • Change of Address Form for Voter Registration: Much like the DL-43 form used for updating personal information on a driver's license, the change of address form for voter registration is essential for ensuring one's voting records are current. Both forms play critical roles in updating governmental records to reflect recent changes in a person's life, such as a move to a new residence.

  • Passport Renewal Form: When a passport holder needs to update their passport due to expiration or changes in personal details, they use a passport renewal form, analogous to the DL-43. Both documents require current personal information and serve the purpose of renewing identification documentation, reaffirming the holder's identity and eligibility under new circumstances.

  • Social Security Card Replacement Form: Similar to the DL-43 form, which is necessary for updating or replacing a driver's license, the Social Security Card Replacement Form is used when someone needs a new social security card. This might be due to loss, theft, or a change in personal information, such as a legal name change.

  • Vehicle Title Transfer Form: This form is used when ownership of a vehicle is transferred from one person to another. It shares similarities with the DL-43 form in terms of being a pivotal document for updating governmental records to reflect a change in status—in this instance, the ownership of a vehicle rather than driver’s license details.

  • Employment Eligibility Verification Form (I-9): The I-9 form is used by employers to verify an employee's eligibility to work in the United States. Like the DL-43, it is integral to verifying personal identity and status, albeit for employment rather than driving purposes. Both forms are essential in their respective fields for maintaining up-to-date and legal records.

  • Professional License Renewal Form: Professionals such as doctors, lawyers, and teachers often must periodically renew their licenses to practice. This process usually requires a form similar to the DL-43, as both deal with the renewal of essential IDs, ensuring that the individual’s credentials remain valid and recognized by the relevant authorities.

Dos and Don'ts

Filling out the DL-43 form, which is often used for driver's license applications or renewals, is an important task that requires careful attention. Here are some essential dos and don'ts to help you complete the form accurately and efficiently:

Do:
  1. Read the entire form before you start filling it out to understand all the requirements.

  2. Use black or blue ink as these colors are generally required and ensure legibility.

  3. Ensure all information is accurate and matches the documentation you provide.

  4. Provide your current address where you receive mail, as this will be used for sending your license and other important information.

  5. Sign the form if a signature is required, as an unsigned form may lead to processing delays.

  6. Double-check dates, such as birthdates or expiration dates, for accuracy.

  7. Ask for help if you’re unsure about any question. Many DMV offices or their websites have resources to assist.

  8. Include any required supporting documents, such as proof of identity or residency.

  9. Keep a copy of the completed form for your records.

  10. Submit the form within any specified deadlines to avoid delays in processing.

Don't:
  • Don’t rush through the form; mistakes can cause delays or require you to start the process over.

  • Don’t use pencil or colors other than black or blue ink as it may not be accepted.

  • Don’t leave required fields empty; if a section doesn’t apply to you, write “N/A”.

  • Don’t guess on answers; verify personal information, especially numbers like Social Security or driver’s license numbers.

  • Don’t omit your signature where one is required. An unsigned form is often considered incomplete.

  • Don’t provide false information. This can lead to serious penalties, including legal action.

  • Don’t fold or damage the form; a neat and clean form makes a good impression and avoids processing issues.

  • Don’t skip the instructions; they can provide valuable guidance on how to fill out each section properly.

  • Don’t ignore the checklist of required documents, if provided, to accompany your form.

  • Don’t be afraid to contact your local DMV if you have questions or need clarification on the process.

Misconceptions

When it comes to handling legal documents, it's easy to get tangled up in misunderstandings and misinformation. The DL-43 form is no exception. Let's clear up some common misconceptions about this form to help you navigate the process more smoothly.

  • It's only for renewing your driver's license. Many people think the DL-43 form is exclusively for renewing a driver's license. However, it's also used for updating personal information, such as your address or legal name, and applying for a duplicate license.

  • You can only submit it in person. In today's digital age, many assume that all government forms must be submitted in person. The DL-43 form, on the other hand, can often be submitted online or through mail, depending on your state's Department of Motor Vehicles (DMV) policies.

  • There's a fee for everyone. While it's true that submitting the DL-43 form usually requires a fee, there are exceptions. Some states waive the fee for seniors, veterans, or individuals with certain disabilities. Always check with your local DMV.

  • Completing the form guarantees approval. Unfortunately, filling out and submitting the DL-43 doesn't guarantee that your request will be granted. The DMV reviews each application carefully and considers various factors before making a decision.

  • Any mistake on the form leads to automatic rejection. Mistakes happen, but they don't always result in automatic rejection. If the error is minor, the DMV may simply request a correction rather than dismiss your application outright.

  • It's a one-size-fits-all form. The belief that one DL-43 form applies universally across all states is a myth. Each state may have its own version of the form with specific requirements and instructions, so it's essential to use the form provided by your state's DMV.

  • There's no deadline for submission. Timing can be crucial. Some uses of the DL-43 form, like renewing your driver's license, are time-sensitive. Missing the deadline could result in fees, or worse, losing your driving privileges temporarily.

  • The form is complicated. While government forms can be daunting, the DL-43 form is designed to be straightforward. Most people find it relatively easy to complete, especially with clear instructions provided by the DMV.

  • You need legal assistance to fill it out. Although legal advice can be helpful in many scenarios, the average person does not need professional help to fill out the DL-43 form. Guidance from the DMV, along with careful reading of the instructions, is usually sufficient.

  • Personal documentation must be submitted with the form every time. Not all situations require you to submit additional documents with the DL-43 form. The need for extra documentation depends on the purpose of your application, such as a name change, which would require legal proof of the change.

Understanding these misconceptions about the DL-43 form can ease the process and alleviate any unnecessary stress. When in doubt, always consult your state's DMV for the most accurate and up-to-date information.

Key takeaways

When it comes to handling the DL-43 form, an essential document for driver's license services in some states, understanding the finer points can make the process smoother. Here are nine key takeaways to keep in mind:

  • Identification is crucial: Before filling out the DL-43 form, ensure you have valid identification. This could be a current driver’s license, a state ID, or a passport. The exact requirements may vary, so it's wise to check with your local DMV.
  • Accuracy matters: Take your time to fill out the form accurately. Mistakes can lead to delays or the need to submit a new form. Double-check all entered information, especially your personal details like name, address, and Social Security number.
  • Application for various services: The DL-43 form is versatile. It can be used for renewing a license, requesting a duplicate, or changing information on your current license, like your address or name. Be clear about the service you’re requesting to avoid any mix-ups.
  • Supporting documents may be required: Depending on your reason for submitting the DL-43 form, you might need to provide additional documentation. For instance, changing your name legally requires a marriage certificate or court order.
  • Signatures are binding: Your signature is one of the most important parts of the DL-43 form. It means you attest to the information being correct and you understand the terms. Make sure not to skip this step.
  • Processing times can vary: After submitting your DL-43 form, be prepared to wait. Processing times differ depending on the DMV’s workload and the service requested. Check online or with your local office for an estimate.
  • There may be a fee: Often, there’s a fee associated with the services requested through the DL-43 form. Fees can vary widely, so it’s best to verify the exact amount with your DMV beforehand. You might also need to know acceptable payment methods.
  • Online options may be available: Some states offer the convenience of filling out and submitting the DL-43 form online. This can save time and might even be faster to process. Check if your state provides this service.
  • Keep a copy for your records: After completing and submitting the DL-43 form, it’s a good idea to keep a copy for your records. If there are any questions or issues later, having a copy can be very helpful.

Handling the DL-43 form doesn't have to be daunting. With these key takeaways in mind, you can navigate the process with greater ease and confidence. Always remember to check with your local DMV for the most current information and requirements specific to your state.

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