ࡱ> i sbjbj.. 4zDbDbv v 8>| F~*(T,DEFEFEFEFEFEFE$GJ^jE]* * * jEHEh%h%h%* FDEh%* DEh%h%6Z?A)=p :@0EE0 FV@K^!K8AA&K$B * * h%* * * * * jEjE("@* * * F* * * * K* * * * * * * * * v B : Ohio Bureau of Motor Vehicles CDL SPEXS Unit P.O. Box 16725 Columbus OH, 43216-6725  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       OHIO DEPARTMENT OF PUBLIC SAFETY BUREAU OF MOTOR VEHICLES CDL SELF-CERTIFICATION AUTHORIZATIONFederal regulations require ALL Commercial Driver License (CDL) holders to self-certify their type of commercial driving. All CDL holders must submit a self-certification in order to be issued and maintain their CDL.NAME OF DRIVER  FORMTEXT      OHIO DRIVER LICENSE NUMBER  FORMTEXT      Please mark only one of the following self-certification categories that apply to you. (See page 2 for category details.) I certify my commercial driving is: FORMCHECKBOX  Category 1: Non-Excepted Interstate: CDL holders who drive across state lines or transport freight that has or will cross state lines and must meet federal medical requirements subject to 49 CFR part 391. A medical card must be submitted to the Ohio Bureau of Motor Vehicles (BMV). FORMCHECKBOX  Category 2: Excepted Interstate: CDL holders who drive across state lines but do not need to meet federal medical requirements. Operating exclusively in transportation or operations excepted under 49 CFR 390.3(f), 391.2, 39168 or 398.3. FORMCHECKBOX  Category 3: Non-Excepted Intrastate: CDL holders who drive exclusively in Ohio and do not drive across state lines, but are required to meet state medical requirements. FORMCHECKBOX  Category 4: Excepted Intrastate: CDL holders who do not use the CDL for business purposes and are not required to meet state medical requirements. Operating exclusively in transportation or operations excepted from all or part of the State driver qualification requirements. Ohio Revised Code (R.C.) 4506.03(B)(1-10).SIGNATURE OF APPLICANT XDATE  FORMTEXT      If you mark category 1, you must also submit a copy of your completed Medical Examiner s Certificate.  FORMCHECKBOX  I have included a Medical Examiner s Certificate.The CDL Self-Certification Authorization form and the Medical Examiners Certificate, if applicable, must be submitted to the Ohio Bureau of Motor Vehicles and processed prior to the issuance of the CDL. The Self-Certification Authorization form and the Medical Examiners Certificate can be submitted by mail, fax, e-mail, or at a Deputy Registrar Office. The forms must be legible or a delay in processing will occur. If you have any questions or require additional information, please visit www.bmv.ohio.gov or direct your inquiries to: Ohio Bureau of Motor Vehicles, CDL SPEXS Unit, P.O. Box 16784, Columbus, Ohio 43216-6784. You can also contact the Ohio BMV at (844) 644-6268, or live chat with a representative at  INCLUDETEXT P:\\Printing Services\\PSS-Electronic Design\\ODPS FORMS & PUBLICATIONS\\BOOKMARKING\\WEBSITES.doc BMVWEB \* MERGEFORMAT  HYPERLINK "http://www.bmv.ohio.gov" www.bmv.ohio.gov.You can submit your documents:By Mail: Ohio BMV Attn: CDL SPEXS Unit P.O. Box 16784 Columbus, OH 43216-6784 Include your name, address, and contact number on all mailingsBy Fax: (614) 308-5181 OR By E-mail:  HYPERLINK "mailto:cdl@dps.ohio.gov" cdl@dps.ohio.gov Include your name, address, and contact number on all faxes and e-mails.In Person: BMV Deputy Registrar Office (listed at  INCLUDETEXT P:\\Printing Services\\PSS-Electronic Design\\ODPS FORMS & PUBLICATIONS\\BOOKMARKING\\WEBSITES.doc BMVWEB \* MERGEFORMAT  HYPERLINK "http://www.bmv.ohio.gov" www.bmv.ohio.gov) Online:  HYPERLINK "https://bmvonline.dps.ohio.gov/Login?method=CDLSelfCertification&authLevelEnums%5B0%5D=DLNumber&authLevelEnums%5B1%5D=Person" Ohio BMV - Online Services View or modify your CDL Self- Certification category on-line.  SELF-CERTIFICATION CATEGORIESAll Class A, B, or C CDL holders and all drivers applying for a Class A, B, or C CDL, at issuance, must certify to one of the self-certification categories listed:Category 1:Non-Excepted Interstate: Operates or expects to operate a commercial vehicle in interstate commerce and is subject to the requirements under 49 C.F.R. part 391. Examples include: All Class A, B, and C drivers who drive across state lines, between two places within a state, but during part of the trip, the CMV crosses into another state, or between two places within a state, but the cargo or passengers are part of a trip that began or will end in another state All Class A, B, and C drivers who do NOT fall under any of the other categories All Class A, B, and C drivers granted a medical variance, federal hearing or seizure exemption, or Skill Performance Evaluation certificate (SPE) (V restriction)Category 2:Excepted Interstate: Operates or expects to operate a commercial vehicle in interstate commerce (across state lines) but engages in operations exclusively excepted under 49 C.F.R. 390.3(f), 391.2, 391.68 or 398.3. Examples include:School bus operations transporting school children and/or school staff between home and school Transportation performed by the federal government, a state, or any political subdivision of a state Occasional transportation of personal property by individuals not for compensation or in the furtherance of a commercial enterprise The transportation of human corpses or sick and injured persons The operation of fire trucks and rescue vehicles while involved in emergency and related operations. A nine (9) to fifteen (15) passenger van, including the driver, weighing less than 26,001 GVWR, not for compensation Apiarian industries (Beekeepers) Either a driver of a commercial motor vehicle used primarily in the transportation of propane winter heating fuel or a driver of a motor vehicle used to respond to a pipeline emergency 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 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 placard-able 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 To transport migrant workersCategory 3:Non-Excepted Intrastate: Operates a commercial vehicle in intrastate commerce (exclusively within the State of Ohio) and subject to state driver qualification requirements. 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