Print this form, complete in full and mail completed form to:
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| Last name: | ______________________________ | |
| First Name: | ______________________________ | |
| Current Driver's License Address: |
______________________________ ______________________________ ______________________________ ______________________________ | |
| Address to Mail IDL: |
______________________________ ______________________________ ______________________________ ______________________________ | |
| Email Address: | ______________________________ | |
| Telephone (For use with this order.): | ______________________________ | |
| Passport #: | ______________________________ | |
| Passport Date of Issue#: | ______________________________ | |
| Passport Place of Issue: | ______________________________ | |
| Place of Birth: | ______________________________ | |
| Date of Birth: | ______________________________ | |
| Nationality: | ______________________________ | |
| Driver's License #: | ______________________________ | |
| State of Issue: | ______________________________ | |
| Date of Issue: | ______________________________ | |
| Expires On: | ______________________________ | |
| Applicant Signature: | ______________________________ | |
| * Not Mandatory | ||
I understand that this international driver's permit (license) is in no way intended to replace a suspended or revoked driver's permit (license) from the United States or any other country, and I am not applying for this international driver's permit to use as such. I do further understand that this international driver's permit (license) will become null and void if a permit is issued and the above is the actual Intention of the applicant. I further release IDL International, Inc. from any and all said liability caused by any misrepresentation on my part. I additionally release IDL International, Inc. from any and all liability caused by applicant's failure to comply with any local, state, national, or international law.IDL INTERNATIONAL'S LIABILITY LIMITED TO THE REFUND OF LICENSE FEE. | ||
 Credit Card # | ______________________________ | |
| Billing Address | ______________________________ | |
| Expiration Date | ______________________________ | |
| Signature of Applicant: | ______________________________ | |
| Date: | ______________________________ | |
Be sure to enclose a Check or Money Order payable to IDL International, Inc. for the correct amount (see table below) and include one (1) passport style photo.
| One (1) year permit | $19.95 + tax and/or regular shipping & handling = | |
| Two (2) year permit | $29.95 + tax and/or regular shipping & handling = | |
| Three (3) year permit | $39.95 + tax and/or regular shipping & handling = | |
| Five (5) year permit | $49.95 + tax and/or regular shipping & handling = | |
| Note: As a convenience, our clients usually prefer multi-year permits. Please be advised that some countries require that you apply for the local permit after one (1) year of continuous residency! | ||
We prefer payment by check or money order; however, credit cards (American Express, MasterCard or VISA) will be accepted for YOUR convenience. All credit card transactions will be billed an additional $5.00 per permit to offset processing fees.
Use this Checklist to avoid delays.
| Appropriate Payment Enclosed | |
| Passport Style Photo Enclosed | |
| Copy of Current Valid Driver's Permit Enclosed | |
| Delivery by 2 Day Air Available Only for US Destinations, Monday through Friday Add $18 |
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| Overnight Delivery Available Only for US Destinations, Monday through Friday Add $25 |
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| Completed Application with Signature Enclosed |
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