Serial number from the Registry of issued DL or IDL (to be filled in by the Road Traffic Authority)*……………………

To be filled in by the applicant:

APPLICATION

for making a change in driver‘s registration

Applicant's details:

Last name ( academic degree) ...................................................................... First name      …………....…………..........…

Last name at birth:......................... Social security number **):...................

Permanent residence (in SK): ……….................................……………………......................................…….......................…..............………........

Type and number of identity card (povolenie na pobyt + its respective #)  Citizenship.............................

I hereby apply for:

......................................................................................................................................…………………….................…..………

......................................................................................................................................……………………............…………….

......................................................................................................................................……………….………..........……………

......................................................................................................................................………………………..............................

Write "vydanie VP" here (issuing a driver's licence) 

At ………….., date……..

______________________________

applicant's signature 

*)  if no new DL is issued, do not fill in

**) if the applicant has not been assigned a social security number, date of birth shall be provided

T MV SR 12-041      III/2001

To be completed by the Road Traffic Authority:

the applicant submitted their DL series :…………….        no.: ………………………. issued on :…………………. by: ……………………

the applicant submitted their IDL of the series: ……… ….  no.: ……………………. issued on :……………. …. by: …………………

if applicable, other documents : ………………………………………………………………………………………………………………

The Applicant has paid duty stamp worth………………………………. 

I confirm that I have accepted into my possession a driver's licence of the series: ………………… No.: ……………………………..

IDL series: ………….. …… no.: …………………………..

___________________________________

applicant's signature 

Place for affixing duty stamps and other notes of the Road Traffic Authority:

_________________________________________

stamp and signature of the RTA employee