Dl 405A PDF Template

Dl 405A PDF Template

The DL 405A form is a document required by the South Carolina Department of Motor Vehicles that outlines the medical certification requirements for Commercial Driver’s License (CDL) holders. This form must be completed by the applicant to ensure compliance with federal regulations regarding the fitness of drivers operating commercial vehicles. To proceed with the certification process, individuals are encouraged to fill out the DL 405A form by clicking the button below.

Overview

The DL 405A form is an essential document for commercial drivers in South Carolina, particularly those holding a Commercial Driver’s License (CDL). This form plays a pivotal role in ensuring that CDL holders comply with federal medical certification requirements, which became mandatory as of February 1, 2012. It must be filled out completely by the applicant, using either black or blue ink, and includes necessary personal information such as the applicant's legal name, date of birth, Social Security number, and driver's license number. In addition, the applicant must select one of several operation types that apply to their driving activities: Non-Excepted Interstate, Excepted Interstate, Non-Excepted Intrastate, or Excepted Intrastate. Each option carries specific implications regarding medical qualification and documentation. For many CDL holders, particularly those engaging in non-excepted interstate commerce, the need for a Department of Transportation (DOT) medical card is critical. Accurate self-certification about the type of commercial operation is essential to maintain licensing and legality on the road. The DL 405A form streamlines the process by allowing applicants to submit their certification along with any associated medical documents through multiple methods, including mail, email, fax, or in person at local DMV offices. Understanding the nuances of the DL 405A form and its requirements can significantly impact a driver’s ability to work legally and safely in commercial transport.

Dl 405A Preview

South Carolina Department of Motor Vehicles

Commercial Driver’s License (CDL) Holders

Medical Certification Requirements

DL-405A

(Rev. 3/12)

THIS ENTIRE FORM MUST BE COMPLETED BY THE APPLICANT

and must be completed in black or blue ink.

CURRENT LEGAL NAME (FIRST, MIDDLE, LAST, SUFFIX)

DATE OF BIRTH

/ /

SOCIAL SECURITY NUMBER

- -

DRIVERS LICENSE NUMBER

CHECK THE APPROPRIATE BOX FOR THE TYPE OF OPERATION THAT APPLIES TO YOU

See Frequently Asked Questions (FAQ) for explanations

NON-EXCEPTED INTERSTATE

(NI)

Operates in interstate commerce and meets the qualification

(Required to have a DOT medical

 

requirements under 49 CFR part 391

card/certificate)

 

 

EXCEPTED INTERSTATE

(EI)

Operates in interstate commerce, but engages exclusively in

(See FAQ Sheet for list)

 

transportation or operations excepted under 49 CFR 390.3(f),

 

 

391.2, 391.68 or 398.3

NON-EXCEPTED INTRASTATE

(NA)

Operates only in intrastate commerce and is subject to and meets

(18-20 years of age and/or

 

State driver qualification requirements.

license with an “Irestriction)

 

 

EXCEPTED INTRASTATE

(EA)

Operates only in intrastate commerce, but engages exclusively in

(Not applicable in South Carolina)

 

transportation or operations excepted from State driver

 

 

qualification requirements.

I certify under penalty of perjury that all statements above are true and correct.

SIGNATURE OF APPLICANT

DATE

If your CDL is current, you may submit this form along with any other documents that apply to you

(Medical Examiner’s Certificate, Federal Waiver, Skills Performance Evaluation) using one of the following options:

1)Mail this form and copies of medical documents to: SCDMV - CDL Help Desk

PO Box 1498

Blythewood, SC 29016-0028

2)Scan the documents and then email them to: CDLHelpDesk@scdmv.net

3)Fax this form and medical documents to the CDL Help Desk. Fax number is (803) 896-2676

4)Deliver this form and medical documents to your local SCDMV office. A list of office locations and hours can be found on our website www.scdmvonline.com

Please contact the CDL Help Desk at (803) 896-2673 if you have any questions regarding this form.

South Carolina Department of Motor Vehicles

New Medical Certification Requirements

A Guide for Commercial Driver’s License (CDL) Holders

Frequently Asked Questions (FAQ)

DL-405A

(FAQ)

(Est. 1/12)

The following FAQs will help you in determining how to meet the new Federal medical certification requirements:

Q.What must I do to comply with the new requirements for making my medical certification part of my CDL driving record?

A.Starting on February 1, 2012, when you:

Apply for a CDL; Renew a CDL;

Apply for a higher class of CDL;

Apply for a new endorsement on a CDL; or Transfer a CDL from another State

You will be required to self-certify to a single type of commercial operation on SCDMV Form DL-405A Commercial Driver’s License Holders Medical Certification Requirements. Based on that self- certification, you may need to provide your current medical examiner’s certificate and show any

variance (Federal Waiver/Skills Performance Evaluation) you may have to obtain or keep your CDL.

Q.How do I determine which type of commercial motor vehicle (CMV) operation I should self- certify?

A.For the purpose of complying with the new requirements for medical certification, it is important to know how you are using the CMV. To help you decide, follow these steps:

Step 1: Do you, or will you, use a CDL to operate a CMV in interstate or intrastate commerce?

Interstate commerce is when you drive a CMV:

From one State to another State or a foreign country;

Between two places within a State, but during part of the trip, the CMV crosses into another State or foreign country; or

Between two places within a State, but the cargo is part of a trip that began or will end in another State or foreign country.

Intrastate commerce is when you drive a CMV within a State and you do not meet any of the descriptions above for interstate commerce.

If you operate in both intrastate commerce and interstate commerce, you must choose interstate commerce.

In the state of South Carolina, Non-excepted intrastate commerce is applicable only to individuals between 18 and 20 years of age and/or with an “I” restriction on his

license.

Step 2: Once you decide you operate or will operate in interstate commerce or intrastate commerce, you must decide whether you operate (or expect to operate) in a non-excepted or excepted status. This decision will tell you which of the four types of commerce you must self-certify.

Interstate Commerce:

You operate in excepted interstate commerce when you drive a CMV in interstate commerce only for the following excepted activities:

To transport school children and/or school staff between home and school; As Federal, State or local government employees;

To transport human corpses or sick or injured persons;

Fire truck or rescue vehicle drivers during emergencies and other related activities;

Page 1 of 2

South Carolina Department of Motor Vehicles

New Medical Certification Requirements

A Guide for Commercial Driver’s License (CDL) Holders

Frequently Asked Questions (FAQ)

DL-405A

(FAQ)

(Est. 1/12)

Primarily in the transportation of propane winter heating fuel when responding to an emergency condition requiring immediate response such as damage to a propane gas system after a storm or flooding;

In response to a pipeline emergency condition requiring immediate response such as a pipeline leak or rupture;

In custom harvesting on a farm or to transport farm machinery and supplies used in the custom harvesting operation to and from a farm or to transport custom harvested crops to storage or market;

Beekeeper in the seasonal transportation of bees;

Controlled and operated by a farmer, but is not a combination vehicle (power unit and towed unit), and is used to transport agricultural products, farm machinery or farm supplies (no placardable hazardous materials) to and from a farm and within 150 air- miles of the farm;

As a private motor carrier of passengers for non-business purposes ; or To transport migrant workers.

If you answered yes to one or more of the above activities as the only operation in which you

drive, you operate in excepted interstate commerce and do not need a Federal medical examiner’s certificate.

If you answered no to all of the above activities, you operate in non-excepted interstate commerce and are required to provide a current medical examiner’s certificate (49 CFR

391.45), commonly referred to as a medical certificate or DOT card. Most CDL holders who drive CMVs in interstate commerce are non-excepted interstate commerce drivers.

If you operate in both excepted interstate commerce and non-excepted interstate commerce, you must choose non-excepted interstate commerce to be qualified to operate in both types of interstate commerce.

Q.Will current CDL Holders be notified of the Self-certification requirement?

A.Yes, all current South Carolina Commercial Driver License and beginner’s permit holders will receive a letter notifying them of the requirement.

Q.What if my Commercial license does not expire until after January 30, 2014?

A.Prior to January 30, 2014 you must self-certify to a single type of commercial operation.

Q.What happens after January 30, 2014 if I have not self-certified my commercial operation?

A.CDL holders who do not meet the January 30, 2014 will be in jeopardy of losing their Commercial

Driver’s License.

Q.How do I self-certify?

A.You may visit any SCDMV field office and complete a form DL-405A (Commercial Driver’s License

Holders Medical Certification Requirements). The form can also be down loaded from our website www.scdmvonline.com and mailed, faxed or email to the CDL Help desk. Depending upon the self- certification you may also need to present a valid DOT medical card.

Mailing Address: SCDMV-CDL Help Desk

PO Box 1498

Blythewood SC 29016-0028

Email Address: cdlhelpdesk@scdmv.net

Fax:

(803) 896-2676

Q.If I have additional questions, who should I contact?

A.You may contact the SCDMV CDL Help Desk at (803) 896-2673.

Page 2 of 2

File Properties

Fact Name Detail
Form Purpose This form is used by commercial drivers in South Carolina to certify their medical qualifications.
Governing Laws The form is governed by federal regulations under 49 CFR 391 and South Carolina state laws related to CMV operations.
Form Revision Date The DL-405A was revised in March 2012.
Completeness Requirement The applicant must complete the entire form using black or blue ink.
Self-Certification Requirement Drivers must self-certify their operation type, either interstate or intrastate, as part of the application or renewal process.
Types of Operation There are four types of operation categories: Non-Excepted Interstate, Excepted Interstate, Non-Excepted Intrastate, and Excepted Intrastate.
Submission Methods Completed forms can be mailed, emailed, faxed, or delivered to a local SCDMV office.
Contact Information The CDL Help Desk can be reached at (803) 896-2673 for questions or clarification regarding the form.

Instructions on Utilizing Dl 405A

Once you have gathered the necessary information, you will need to fill out the DL-405A form accurately. Following these steps ensures that your application is processed efficiently and effectively.

  1. Begin by using black or blue ink to complete the form.
  2. Fill in your current legal name by writing your first, middle, last name, and suffix if applicable.
  3. Enter your date of birth in the format MM/DD/YYYY.
  4. Provide your Social Security number in the format XXX-XX-XXXX.
  5. Input your driver’s license number.
  6. Check the appropriate box that corresponds to the type of operation that applies to you:
    • Non-excepted Interstate (NI)
    • Excepted Interstate (EI)
    • Non-excepted Intrastate (NA)
    • Excepted Intrastate (EA)
  7. At the bottom of the form, certify that all statements made are true by signing your name where it indicates for the signature of applicant.
  8. Date your signature.

After you have completed the form, you can submit it along with any necessary medical documents. Choose your preferred method of submission: mail, email, fax, or in-person delivery to your local SCDMV office. If you have any questions during this process, the CDL Help Desk is available to assist you.

Important Facts about Dl 405A

What must I do to comply with the new requirements for making my medical certification part of my CDL driving record?

Starting from February 1, 2012, it is essential to self-certify on the DL-405A form when you apply for, renew, or transfer a Commercial Driver’s License (CDL). This self-certification involves selecting a single type of commercial operation. Depending on your choice, you may also need to provide your medical examiner’s certificate, as well as note any variances you hold, such as Federal Waivers or Skills Performance Evaluations.

How do I determine which type of commercial motor vehicle (CMV) operation I should self-certify?

To identify the correct type of CMV operation, first, determine whether you will be driving in interstate or intrastate commerce. Interstate commerce involves traveling across state lines or involving destinations that do. In contrast, intrastate commerce is limited to activities within a single state. If you engage in both, you should self-certify for interstate commerce. Next, decide if you operate in a non-excepted or excepted status, which will direct you to the appropriate choice among the four types on the form.

Will current CDL holders be notified of the self-certification requirement?

Yes, the South Carolina Department of Motor Vehicles (SCDMV) will send a notification letter to all current CDL and beginner’s permit holders. This letter will inform you about the self-certification requirement and any actions you may need to take.

What if my commercial license does not expire until after January 30, 2014?

If your CDL does not expire until after January 30, 2014, you are still required to self-certify your type of commercial operation before that date. Failing to do so may impact your licensing status.

What happens after January 30, 2014, if I have not self-certified my commercial operation?

CDL holders who do not self-certify by January 30, 2014, risk losing their Commercial Driver’s License. It is crucial to complete the self-certification process on time to maintain compliance.

How do I self-certify?

Self-certification can be completed at any SCDMV field office using the DL-405A form. You can also download the form from the SCDMV website, fill it out, and submit it via mail, fax, or email to the CDL Help Desk. Be prepared to present a valid DOT medical card, as it may be required based on your self-certification.

If I have additional questions, who should I contact?

For any further inquiries, reach out to the SCDMV CDL Help Desk at (803) 896-2673. They are ready to assist with your questions regarding the DL-405A form and certification requirements.

Common mistakes

Filling out the DL-405A form correctly is crucial for all commercial driver’s license (CDL) holders in South Carolina. However, many applicants make common mistakes that can lead to delays or complications in their application process. Understanding these pitfalls can help ensure a smoother experience.

One significant error involves not completing the entire form. Each section requires specific information, including the applicant's legal name, date of birth, Social Security number, and driver’s license number. Incomplete forms can be rejected, which means applicants must start over, possibly delaying their ability to operate commercially. Careful attention to detail while filling out every section is essential.

Another frequent mistake is failing to check the appropriate box indicating the type of operation. There are specific categories – such as non-excepted interstate or excepted intrastate. Misclassifying oneself can lead to the need for additional documentation that the applicant might not be prepared to provide, such as a DOT medical certificate. Understanding the definitions and requirements of each type of operation is vital.

Many applicants also neglect to use black or blue ink. The instructions clearly state that the form must be completed in these colors. Using other ink colors can render the document illegible or non-compliant, leading to potential processing issues. Following this simple guideline can prevent unnecessary complications.

Finally, the signature date is often overlooked. It is crucial for applicants to sign and date the form accurately. An incorrectly dated signature might lead to questions about the form’s validity, which can further delay the application process. Ensuring that the signature is recent and corresponds with the application submission time is an important detail that applicants should not disregard.

By recognizing and avoiding these common mistakes when completing the DL-405A form, CDL holders can help facilitate a smoother application process and ensure compliance with South Carolina’s regulations.

Documents used along the form

The DL-405A form serves as an essential component of medical certification for commercial driver’s license (CDL) holders in South Carolina. Often, it is accompanied by several other important forms and documents that play a critical role in ensuring compliance with federal and state regulations. Below is a list of documents frequently submitted alongside the DL-405A form.

  • Medical Examiner’s Certificate: This certificate confirms that a commercial driver has undergone a medical examination and is cleared to operate a commercial motor vehicle (CMV). It must be issued by a registered medical examiner and is a requirement for those in non-excepted interstate commerce.
  • Federal Waiver: In special circumstances, a waiver can be granted to a driver who does not meet standard medical criteria but can prove their ability to safely operate a CMV. This document is crucial for those seeking to drive despite certain medical conditions.
  • Skills Performance Evaluation (SPE) Certificate: This certificate is provided to drivers who have demonstrated their capability to control a CMV despite physical limitations. It serves as an endorsement of their skills and is important for maintaining their CDL.
  • Application for Commercial Driver’s License (CDL) Form: This is the initial application submitted by individuals seeking to obtain their CDL. It includes basic identification information and serves as the first step in the licensing process.
  • CDL Renewal Application: This document is required when a driver’s commercial license is nearing expiration. It ensures that the individual continues to meet all necessary medical and operational qualifications.
  • Endorsement Application: When CDL holders wish to add endorsements to their license—such as for hazardous materials or passenger transport—they must complete this application to demonstrate their additional qualifications and meet mandated requirements.
  • Self-Certification Documentation: This document is necessary for drivers to confirm the type of commercial operation they will be engaging in, thus guiding the determination of which medical requirements apply to them.

Each of these documents plays a vital role in promoting safety and regulatory compliance for commercial drivers. Collectively, they help ensure that those behind the wheel of commercial vehicles meet the necessary health and operational standards set forth by authorities. It is crucial for drivers to be aware of these requirements and prepare their documentation accordingly.

Similar forms

The DL-405A form is essential for commercial driver’s license (CDL) holders in South Carolina. It ensures compliance with medical certification requirements. Several other documents share similar functions or purposes. Here are five comparable forms:

  • Medical Examiner’s Certificate: This document certifies that a driver meets the necessary medical standards to operate a commercial vehicle. It functions as a proof of medical fitness, similar to how the DL-405A self-certifies the type of operation.
  • Federal Waiver: A Federal Waiver may be granted to drivers who don't meet the standard medical requirements but can still safely operate a commercial vehicle. Like the DL-405A, it denotes special circumstances and compliance needs.
  • Skills Performance Evaluation (SPE) Certificate: This certificate verifies a driver’s ability to operate a commercial vehicle despite physical limitations. It is directly comparable to the DL-405A in that it involves an assessment of qualifications which must be documented.
  • Form MCSA-5876 - Medical Examination Report: This federal form includes a detailed examination report completed by a certified medical professional. It relates closely to the DL-405A in that both are integral to documenting medical fitness to obtain or maintain a CDL.
  • CDL Application Form: This is the initial application for obtaining a commercial driver’s license. It usually requires medical documentation, making it similar to the DL-405A, as both involve proving a driver’s qualifications to operate commercial vehicles.

Dos and Don'ts

When filling out the DL-405A form, it's important to follow key guidelines to ensure your application is processed smoothly. Here’s a helpful list of dos and don'ts:

  • Do complete the entire form in black or blue ink.
  • Do provide your current legal name, date of birth, social security number, and driver's license number accurately.
  • Do check the appropriate box that corresponds to your type of operation carefully.
  • Do sign and date the form to certify your statements are true and correct.
  • Don’t leave any sections of the form blank; all fields must be filled out.
  • Don’t forget to attach any necessary medical documents, such as your Medical Examiner’s Certificate, if applicable.
  • Don’t submit the form through any method other than those specified: mail, email, fax, or in-person delivery to the SCDMV office.

Pay attention to these guidelines, as they can help prevent delays in your CDL application process.

Misconceptions

  • The DL-405A form is only for new CDL applicants. This is a common misconception. The DL-405A form is required not just for new applicants but also for those renewing their CDL or transferring a CDL from another state.
  • You do not need to provide medical documentation if you are self-certifying. In many cases, applicants must submit a current medical examiner’s certificate along with the DL-405A form, depending on the self-certification type they choose.
  • Self-certification is optional. Many CDL holders believe that self-certification is optional. In fact, it is mandatory for all CDL holders to self-certify the type of operation they will be doing.
  • All CDL holders need a medical certificate. This is misleading. Only those who are engaged in non-excepted interstate commerce require a valid medical certificate, while those in excepted categories do not.
  • You can submit the DL-405A form anytime. There is a deadline for self-certification. CDL holders must complete this form by specific dates or risk penalties, including suspension of their license.
  • The DL-405A form can be filled out in any color ink. In fact, applicants must complete the form using either black or blue ink only.
  • The form is not required if you only drive within your state. While some exemptions apply, certain intrastate drivers still need to complete the DL-405A form based on their qualifications.
  • Your CDL cannot be suspended for failure to submit the DL-405A form. That’s incorrect. A failure to submit this form by the required deadline can lead to suspension of your CDL.
  • Only commercial drivers need to worry about the medical certificate. Many people think it's only relevant for truck drivers. However, any individual operating a commercial motor vehicle (CMV) may be affected, which includes a variety of professions.

Key takeaways

Filling out and using the DL-405A form is an essential process for maintaining compliance with commercial driver’s license medical certification requirements in South Carolina. Below are key takeaways regarding this form:

  • Complete the Form Accurately: The entire DL-405A form must be filled out by the applicant in black or blue ink, ensuring all information is correct and complete.
  • Self-Certification: As of February 1, 2012, all CDL applicants must self-certify their type of operation, which may require providing a medical examiner's certificate.
  • Types of Operations: Applicants need to determine whether they operate in non-excepted interstate, excepted interstate, non-excepted intrastate, or excepted intrastate commerce.
  • Submission Options: Completed forms can be mailed, scanned and emailed, faxed, or delivered in person to a local SCDMV office for processing.
  • Know Your Deadline: It is crucial to self-certify before January 30, 2014, or risk losing the CDL.
  • Stay Informed: Current CDL holders will receive notification letters outlining the self-certification requirement, ensuring awareness and compliance.
  • Contact for Assistance: If there are questions or uncertainties regarding the form, applicants should reach out to the SCDMV CDL Help Desk for guidance.

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