|
Driver's License Application for Tri-state (KY, IN,IL)
Contributed By: Steve Kares
1. Name _________________________________________________
(KY residents fill out line 1 as fully as possible. This completes your
application.)
2. Amount of income remaining after paying federal income tax, state income
tax, and state sales tax____________
(Indiana residents only: The amount on line 2 is the fee for license
plates.)
3. Address________________________________________________
This address is:
a) my actual address [ ]
b) the address of someone I know [ ]
c) completely ficticious [ ]
4. Name of insurance company __________________________________
(If you don't have insurance or can't remember the name of your
company, make one up)
5. Have you:
a) Passed the driving test in the state of residence at any time [ ]
b) Passed the driving test in any other state or foreign country [ ]
c) Passed the age of 60 [ ]
d) None of the above [ ]
(If none of the above, you must take a driving test)
6. Do you wish to have issued a low number license plate? Yes [ ] No [ ]
If Yes, are you:
a) a politician [ ]
b) an attorney [ ]
c) a doctor [ ]
d) all the above [ ]
e) none of the above [ ]
(Only persons checking a, b, c, or d will be issued said plate)
7. Do you wish to be an organ donor? Yes [ ] No [ ]
If Yes, do you wish to have organs removed:
a) at the accident scene [ ]
b) while enroute to the hospital [ ]
c) only after death is certified by licensed medical practicioner [ ]
If No, please attach a separate statement detailing your reasons why
not. This statement must be typewritten, double-spaced and no less than 5
(five) pages.
FEES
1. Do you hereby swear and affirm that, to the best of your knowledge, the
above statements are true?
Yes [ ] Fee $ 5.00
No [ ] See question 2
2. Are most of the above statements true?
Yes [ ] Fee $ 50.00
No [ ] See question 3
3. Are all the above statements completely false?
Yes [ ] Fee negotiable
No [ ] See question 1
|
