PRINTABLE APPLICATION
Please print this form, fill out and send it with your payment to: For official use only 1162 St. Georges Ave., Suite # 293
Avenel NJ 07001, USA KRASCAR INTERNATIONAL TRAVEL CLUB INC.
FOR OFFICIAL USE ONLY
Attention: additional charge $5.00 will apply if you fillout printable application by hand no any additional charges if you apply online at http://IDLicense.com/app
INFORMATION AS PRINTED ON YOUR NATIVE DRIVER LICENSE First name: |___|___|___|___|___|___|___|___|___|___|___|___|___|___| Last name: |___|___|___|___|___|___|___|___|___|___|___|___|___|___| Address: |___|___|___|___|___|___|___|___|___|___|___|___|___|___|___| |___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___| City: |___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___| State/Province: |___|___|___|___|___|___|___|___|___|___|___|___|___| ZIP/Post Code: |___|___|___|___|___|___|___|___|___|___|___|___| Country: |___|___|___|___|___|___|___|___|___|___|___|___|___|___| MAILING ADDRESS (LEAVE BLANK IF THE SAME) First name: |___|___|___|___|___|___|___|___|___|___|___|___|___|___| Last name: |___|___|___|___|___|___|___|___|___|___|___|___|___|___| Address: |___|___|___|___|___|___|___|___|___|___|___|___|___|___|___| |___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___| City: |___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___| State/Province: |___|___|___|___|___|___|___|___|___|___|___|___|___| ZIP/Post Code: |___|___|___|___|___|___|___|___|___|___|___|___| Country: |___|___|___|___|___|___|___|___|___|___|___|___|___|___|
Date of Birth: _____|_____MM______|_____DD______|_______YY Country of Birth: |___|___|___|___|___|___|___|___|___|___|___|___|___| Gender(male, female) : __F___|___M____| (CIRCLE) Eye color: |___|___|___|___|___|___|___|___|___|___|___|___|___| Height: |___|___|____| CM |___| FEET |___| INCHES DRIVER’S LICENSE # |___|___|___|___|___|___|___|___|___|___|___| Exp. Date: _____|_____MM______|_____DD______|_______YY
CONTACT INFORMATION E-Mail: |___|___|___|___|___|___|___|___|___|___|___|___|___|____|___| Phone: |___|___|___|___|___|___|___|___|___|___|___|___|
1 YEAR VALIDITY - $35.00 3 YEARS VALIDITY - $50.00 5 YEARS VALIDITY - $65.00 10 YEARS VALIDITY - $85.00 20 YEARS VALIDITY (GOLDEN WITH ELECTRONIC CHEAP) - $150 5 YEARS NON GOVERNMENT ID CARD - $25.00 INSURANCE FOR ALL OF IDL’s - $ 7.99 INSURANCE FOR GOLDEN IDL - $ 12.99 HANDLING THIS APPLICATION - $ 5.00 International Shipping Rates Prices DHL International $ 45.00 DHL Express International $ 59.00 United States Shipping Rates Prices
Category : |_A_| MOTORCYCLES |_B_| PASSENGER CARS |_C_| VEHICLES OVER 7,700 Lbs |_D_| VEHICLES OVER 8 SEATS |_E_| VEHICLES OF B,C, OR D with other that a light trailer |___| NON GOVERNMENTAL ID CARD
To order an International Translation of Driver’s License for more than a one year validity period you represent that your driver’s license will either be valid for such a period, automatically renewed or will renew your license in your country of origin. Validity periods maintain your validity status provided that the native original driver’s license is valid for that same period
USPS Regular Mail $ 1.00 USPS Priority mail $ 5.00
USPS Priority mail ( trackable ) $ 6.00 USPS Express mail (Within USA) $ 17.00 DHL Three Day Select (Within USA) $ 12.00 DHL Second Day Air (Within USA) $ 24.00 DHL Next Day Air (Within USA) $ 39.00
Payment method
Money order #__________________________________ Personal or Company Check #_____________________ Western Union #________________________________ Sender’s First and Last name ______________________________________
Credit or Debit card Name on the credit card |___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___| Card #: |___|___|___|___|___|___|___|___|___|___|___|___|___|___|___| Exp. date: |___|___| VISA, MASTERCARD, AMERICAN EXPRESS, DISCOVERY MONTH
|___|___|___|___| YEAR
For MasterCard or Visa the 3-digit CVV which |___|___|___|___| can be found after the account number on the back of the card Billing Address of CC |___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|
|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|
I, the client, confirm that my native driver’s license is valid, issued by a government entity, not subject to revocation or suspension. I acknowledge that my International Translation of Driver’s License is not a standalone document, and must be go together with by my valid native driver’s license. I acknowledge that it is my obligation to verify with the local authority the rights to use a translation of my native driver’s license.
Note: Applications without payment or credit card info cannot be processed Be sure met all requirements for International Translation of Driver License:
1. Signed Application 2. One Photo (any sizes) 3. Copy of Native Driver License (both sides) 4. Payment |___| |___| |___| |___|
Do not forget include in payment shipping cost and $5 for handle this application
ATTACH ONE COLOR PHOTO (ANY SIZES)
SIGNATURE HERE (WRITE CLEARLY BELOW)
ATTACH COPY OF YOUR NATIVE DRIVER LICENSE