CERTIFICATE OF ELIGIBILITY
VETERANS DRIVER'S LICENSE/IDENTIFICATION CARD
PART I - APPLICATION: I hereby apply for a Veterans, Honorary Veterans, or Disabled Veterans Driver's License/Identification
Card as provided for in Chapter 5 of Title 40 of the Official Code of Georgia Annotated.
(First) (Middle) (Last)
(Street and No.)
(City) (State) (Zip)
Date of Birth:________________Place:________________
(Mo. Day Yr.) (State)
Check the appropriate boxes:
I'm a veteran and have been a resident of the State of
Georgia for 2 or more consecutive years immediately prior
to this date of application.
I'm now the lawful spouse of the above identified
I'm the surviving spouse of a deceased
veteran and I have not remarried since such death.
Applicant's Certificate - I certify that the foregoing statements made by me on this application are true and correct.
* Penalty- The law provides severe penalties which include fine or imprisonment or both, for the willful submisson of any statement or evidence of a material
fact, knowing it to be false.
Notice to Veteran or spouse: You must complete PARTI and sign it in the presence of a
representative of the Georgia Department of Veterans Service, who will then complete
PARTII. Official records must be presented to support residency and service claims.
You must present the completed form to any driver license examiner of the Department of
Motor Vehicle Safety who is responsible for the issuance of the Veterans License.
In addition to conclusive identification the driver examiner may review the documentation
presented to T