alaska military skills test waiver application pdf

alaska military skills test waiver application pdf, military cdl waiver Form pdf, Form 416, alaska 416 application pdf, military cdl waiver alaska, cdl waiver form pdf, military waiver form application print, military cdl waiver alaska, alaska military cdl waiver application, military cdl waiver, military cdl waiver Application pdf,

Form 4 16 (Rev. 12 /20 22) alaska.gov/dmv STATE OF ALASKA DIVISION OF MOTOR VEHICLES APPL ICATION FOR MILITA RY SKILL S TEST WAIVER The Commercial Driver License (CDL) skills test waiver form may be used by service members who are currently licensed and who are or were employed within the last year in a military position requiring the operation of a military motor vehicle equivalent to a Commercial Motor Vehicle (CMV). This waiver allows a qualified service member to apply for a CDL without skills testing. [§383.77] CDL knowledge (written) test(s) cannot be waived. The transfer of School Bus(S) and/or Passenger (P) endorsements under this Waiver Program are prohibited. [2 AAC 90.420] APPLICANT INFORMATION NAME (Last, First, Middle) STATE /DRIVER LICENSE NUMBER (required) APPLICATION DATE RESIDENCE ADDRESS (STREET) CITY STATE ZIP CODE MAILING ADDRESS (IF DIFFERENT) CITY STATE ZIP CODE DRIVER RECORD CERTIFICATION ( During the 2 - year period immediately preceding this date) 1. Have you had more than one license (except for a military license)? .... ................................ ...............................  YES  NO 2. Has your license been suspended, revoked, cancelled or disqualified in this or any state? ................................ ..  YES  NO 3. Have you been convicted of any violations described below in any type of motor vehicle? • Being under the influence of alcohol as prescribed by state law ..........................................................................  YES  NO • Being under the influence of a controlled substance ............................................................................................  YES  NO • Having an alcohol concentration of 0.04 or greater while operating a CMV .......................................................  YES  NO • Refusing to take an alcohol test as required by a State jurisdiction under its implied consent laws or regulations as defined in 49 CFR 383.72 .............................................................................................................  YES  NO • Leaving the scene of an accident .........................................................................................................................  YES  NO • Using the vehicle to commit a felony (other than manufacturing, distributing or dispensing a controlled substance) ............................................................................................................................................................  YES  NO • Driving a CMV while your CDL is revoked, suspended, cancelled; or you are disqualified from operating a CMV .....................................................................................................................................................................  YES  NO • Causing a fatality through the negligent operation of a CMV (including motor vehicle manslaughter, homicide by motor vehicle, or negligent homicide) .............................................................................................................  YES  NO • Using the vehicle in the c ommission of a felony involving manufacturing, distributing, or dispensing a controlled substance .............................................................................................................................................................  YES  NO • Using a CMV in the commission of a felony involving an act or practice of severe forms of trafficking in persons, as defined and described in 22 U.S.C. 7102(11) ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ...  YES  NO 4. Have you had more than one conviction for any of the violations described below in any type of motor vehicle? • Speeding in excess of 15 mph or mor e above the posted speed limit .................................................................  YES  NO • Driving recklessly, as defined by State or local law or regulation (including offenses of driving a motor vehicle in willful or wanton disregard for the safety of persons or property) .....................................................................  YES  NO • Mak ing improper or erratic lane changes ...........................................................................................................  YES  NO • Following the vehicle ahead too closely ...............................................................................................................  YES  NO • Violating State or local law relating to motor vehicle traffic control (other than a parking violation) arising in connection with a fatal accident .........................................................................................................................  YES  NO • Driving a CMV without obtaining a CDL ...............................................................................................................  YES  NO • Driving a CMV without a CDL in the driver’s possession ......................................................................................  YES  NO • Driving a CMV without the proper class of CDL and/or endorsements for a specific vehicle group being operated or for the passengers or type of cargo being transported ......................................................................  YES  NO • Violating a State or local law or ordinance on motor vehicle traffic control prohibiting texting while driving .......  YES  NO • Violating a State or local law or ordinance on motor vehicle traffic cont rol restricting or prohibiting the use of a hand held mobile telephone while driving ................................ ................................ ................................ ..........  YES  NO 5. Have you had any conviction for a violation of military, state or local law relating to motor vehicle traffic control (other than parking violation) arising in connection with any traffic accident and have no record of an accident in which you were at fault? .............................................................................................................. .  YES  NO CERTIFICATION OF DRIVING EXPERIENCE • Have you been regularly employed or were you regularly employed within the last year in a military position requiring the operation of a military motor vehicle that was representative of a commercial motor vehicle (CMV)? ................  YES  NO • Were you exempted from the CDL licensing requirements for driving a military vehicle on state roads and highways in accordance with 49 CFR §383.3 (c)? ..............................................................................................  YES  NO • Have you operated a military motor vehicle representative of the commercial motor vehicle (CMV) that y ou operate or expect to operate, for at least the 2 years immediately preceding discharge from the military ? ........  YES  NO I certify under penalty of perjury that the information on this form is true and correct to the best of my knowledge, information and belief. APPLICANT’S SIGNATURE DATE Form 4 16 (Rev. 12 /20 22) alaska.gov/dmv CO MM A NDI N G O F F IC E R’S C E R T I F I CA T I O N O F C O MM E RCIAL D R I V ING EXPE RI E NCE CO MMA NDING OFFIC ER’S NAME (L AST , FIRST , MIDDL E) / RANK TEL EPHONE NUM BER S T R EE T A DDR E S S CI T Y S T A T E Z IP CODE COUN T Y SE R V I C E M E M B E R’S D A T E OF QU A LI F IC A T ION: FROM TO SE R V I C E M E M B E R’S N A M E EXPIR AT ION D ATE ( US Gov’t Motor V ehi cle Ope rator Ide ntif icati on Card / Lice nse) Circle the hi gh est cl ass of vehicles t he service m em ber has been driving : C l ass V eh i c l e D e s cr i p t i o n E X A M P L E O F V E H I C L E S IN G R OUP A * 5 th W HE EL - Truc k Tract or/ Sem itr ail er Any combina tion of ve hicles w ith a GC WR of 26, 001 or more po unds provided the G VWR of the ve hicle(s) being to wed is in ex cess of 10, 000 po unds. A * PINTLE HOOK - T ruc k Tra iler C ombination Any combi na tion of ve hicles w ith a GC WR of 26, 001 or more po unds provided the G VWR of the ve hicle(s) being to wed is in ex cess of 10, 000 po unds. B Any sin gle veh icle w ith a GVWR of 26 ,001 o r mo re po unds or an y su ch ve hi cle towing a ve hicle no t in e xcess of 10,000 pounds GVWR. Th e vehicle th e serv ice m em ber ope rates is equ ipped with a full air br ake system :  YES  NO Th e vehicle th e serv ice m em ber ope rates is equ ipped with an air-ove r-hyd raulic bra king sy stem:  YES  NO Th e transm issi on in th e veh icl e th e serv ice m em ber ope rates is:  AUTOMATIC  MANUAL I certify tha t the service member named on t he f ront of this do cume nt is/was assi gned in a job/a ssignme nt r equiri ng t he oper ati on of a commercial mot or vehi cle , t he service member’s dri ving experience has been verifie d; and t he inf ormati on pro vided herein is t rue a nd c orrect to my k now ledge , inform ati on a nd b elief. I als o certif y tha t I am an o ffi cer of the Armed For ces with t he aut hority to admini ste r o aths ; and who has t he g enera l pow ers of a nota ry p ublic. SIGNATURE DATE Au thority of Ar ticle 136, Unifo rm Code of Milit ary Justi ce or 10 U.S.C. 1044A