IDL Application Form for Agents Only

This application is for use of authorized agents only!
Client's Full Name*

First NameLast Name
Client's Residence Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Client's Mailing Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Agent Email*
Agent Phone Number

Area CodePhone Number
Client's Date of Birth*

MonthDayYear
Client's Country of Birth*
Client's Gender*
Client's Eye Color*
Client's Height*
Unit of Measurement used*
Unit of Measurement
Image Uploads
Photo of Applicant*

Please upload a photo of yourself facing front with no glasses or hat and a blank background.
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Proof of ID of Applicant*

Any foreign identification. This can be passport, matriculate consulate ID, birth certificate, voter ID, etc.
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Conditions

By submitting this application, I the applicant acknowledge and adhere to all federal, state, and local regulations, as well as the requirements for international transit. I understand that a valid driver’s license is essential and a requirement for operating a vehicle, and my international driver’s document serves as a translation, not a standalone document. It must always be accompanied by a valid driver’s license issued by the applicant’s country of origin and unexpired. Please note that this international driving document is not an official or government-issued document.
Option A- Photo file upload of Signature of Applicant (Not agent signature) Use this option if you want to upload applicants' signature, if not then please skip down to option B to have client sign with their finger or computer mouse.

Please upload your signature on a blank background, you can choose between this option or signing below. Any of both options are accepted.
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Option B- Applicant Signature (Not agent signature) manually sign with finger or computer mouse.

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Option A- Agent Signature- TO ALL AGENTS: BY YOUR SIGNATURE, YOU ASSERT AND ACKNOWLEDGE THAT YOU HAVE VERIFIED THAT THE INFORMATION PROVIDED WAS COLLECTED AND SUBSTANTIATED TO BE ACCURATE AND TRUE. You are to keep client files on record for a minimum of 7 years. NOTICE- Incorrect information provided by you or your client on the submitted application will require a reissuance fee of $35.00 plus shipping and handling, so please verify all information when filling out client's information.

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Agent's Printed Name

First NameLast Name
Option B- Photo file upload of Agent Signature. Use this option if you want to upload a file of your saved signature.

Please upload your signature on a blank background, you can choose between this option or signing below. Any of both options are accepted.
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I accept these conditions.
Should be Empty:

IDL Application Form for Agents Only

Image Uploads

JS International Drivers Club LLC

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