Questionnaire
For the receipt of International drivers license you must fill a next questionnaire in Latin a letter as in Your passport or confirmative documents.
№
|
Title
|
These club members
|
1
|
FIRST NAME
|
IVAN
|
2
|
LAST NAME
|
IVANOV
|
3
|
DOB:
|
dd.мм.yy. 19.07.1970
|
4
|
COUNTRY OF BIRTH
|
RUSSIA - VORONEZH
|
5
|
ADDRESS
|
BARO ATALAYA 12, VILLANUEVA, MALAGA
|
6
|
Zip Code
|
23456
|
7
|
COUNTRY
|
SPAIN
|
8
|
SEX
|
M
|
F
|
9
|
EYES
|
Blue
|
Green
|
Brown
|
Gray
|
Black
|
10
|
HT
|
1 – 76
|
11
|
NATIONAL DRIVERS LICENCE
|
MOS № 123456 Date of receipt 16.11.2002 - 16.11.2032
|
12
|
KATEGORY
|
A1
|
A
|
B
|
BE
|
C1
|
C
|
C1E
|
CE
|
D1
|
D
|
D1E
|
DE
|
T
|
T/S
|
13
|
IDENTIFICATION CODE:
|
№ 1234567890
|
14
|
BLOOD TYPE
|
O (I) Rh + O(I)Rh+; A(II)Rh+; B(III)Rh+; AB(IV)Rh+.
|
15
|
ALLERGIC
|
Yes
|
No
|
16
|
DIABETIC
|
Yes
|
No
|
17
|
PASSPORT
|
PC № 234567
|
issued 24.05.2005
|
expires 24.05.2015
|
18
|
Yrs
|
1 YRS
|
3 YRS
|
5 YRS
|
10 YRS
|
19
|
DELIVERY TO
|
BARO ATALAYA 12, VILLANUEVA, MALAGA, 23456, SPAIN
|
20
|
URGENT SERVICE
|
12-21 DAYS - 10€
|
3-12 DAYS - 20€
|
INTERNATIONAL MAIL EXPRESS - 40€
|
To fill a questionnaire, select in a group necessary, to affix signature in a necessary square, to fasten photo and to deport by mail or e-mail
Category:
A1 |
Motor cycle easy |
A |
Motor cycle of |
B |
Passenger car of |
ВЕ |
Passenger car with the trailer of |
C |
A freight transport vehicle is more than 3500 kg (7700 pound) of |
C1 |
A freight transport vehicle is to 3500 kg (7700 pound) THIS Freight transport vehicle more than 3500 kg (7700 pound) with the trailer of |
C1Е |
Freight transport vehicle to 3500 kg (7700 pound) with the trailer of |
D |
A transport vehicle is more than 8 passenger places of |
D1 |
A transport vehicle is less than 8 passenger places of |
DE |
A transport vehicle more than 8 passenger places with the trailer of |
D1E |
A transport vehicle less than 8 passenger places with the trailer of |
Т |
Tractor of |
T/S |
Trolleybus |
Postal destination address:
(any citizen can get documents to address which specify in a questionnaire)
Mark a postal address and name of recipient here.
Name:
Last name:
Address / street / house / apartment:
City/Village:
Area / State / Edge:
Index:
Country:
Photo, Signature
(A picture can be prescanned in the coloured image with permission in 300 dpi, signature – 600 dpi in a black and white image a size 550 pixels and to save in JPEG.)
Urgent service (additionally 20 €)
Download Questionnaire