Form DL-43 "Application for Renewal/Replacement/Change of a Texas Driver License or Identification Card" - Texas (English/Spanish)

What Is Form DL-43?

Form DL-43, Application for Renewal/Replacement/Change of a Texas Driver License or Identification Card, is a legal document completed by Texas residents to renew their driver licenses and identification cards, to request their replacement or update the information in these documents. You may renew your identification card and driver license up to two years before and after their expiration dates. Visit your local driver's license office and present Texas DL-43 Form, proof of U.S. citizenship, identity document, and social security card.

This form was released by the Texas Department of Public Safety (TxDPS) on January 1, 2018. A fillable DL-43 Form is available for download below. The second page of the form contains the Spanish version of the application - you may use it for your convenience.

However, this form is no longer applicable. It was replaced by Form DL-14A, Texas Driver License or Identification Card Application for Adults, which can also be found on our website.

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Form DL-43 Instructions

Provide the following information in the DL-43 Application:

  1. Indicate the applicant's details - full name, maiden name, date of birth, social security number, sex, weight, eye color, height, race or ethnicity. Add your contact information - telephone numbers and email address - and write down your residence and mailing addresses;
  2. State you are a citizen of the United States and whether you would like to be registered to vote. If you wish, you may also donate money to various charity programs and to register as an organ donor. If you have a health condition that might impede communication with a law enforcement officer, list it and attach Form DL-101, Physician's Statement. You may waive the application fee if you qualify as a veteran by presenting a letter from the Department of Veterans Affairs or proof of honorable discharge. Provide contact information of two individuals to be contacted in the event of injury or death;
  3. When renewing a driver's license, answer to medical questions. If you have ever been treated for a medical condition or you have a mental condition, diabetes, or alcohol and drug dependencies that may affect your ability to safely operate a motor vehicle, answer "yes";
  4. Confirm the information in the application is true and correct. Indicate the type of residence you currently live in, agree to report to the TxDPS any changes in your medical condition that may affect your driving ability, sign and date the form.
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Download Form DL-43 "Application for Renewal/Replacement/Change of a Texas Driver License or Identification Card" - Texas (English/Spanish)

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(Replacement also called Duplicate)
APPLICATION FOR RENEWAL /REPLACEMENT/CHANGE
OF A TEXAS DRIVER LICENSE OR IDENTIFICATION CARD
DL or ID NUMBER
APPLICANT INFORMATION
CONTACT INFORMATION
LAST NAME:
HOME PHONE:
FIRST NAME:
OTHER PHONE:
MIDDLE NAME:
EMAIL:
SUFFIX:
ADDRESS INFORMATION
MAIDEN NAME:
RESIDENCE ADDRESS:
DATE OF BIRTH (mm/dd/yyyy):
CITY:
STATE:
SSN:
ZIP CODE:
COUNTY:
SEX: (Mark One)
MALE
FEMALE
WEIGHT: lbs.
MAILING ADDRESS:
EYE COLOR:
HEIGHT: ft.
in.
CITY:
STATE:
RACE/ETHNICITY:
(I) American Indian /Alaska Native
(A) Asian / Pacific Islander (B) Black (H) Hispanic (O) Other (W) White
ZIP CODE:
COUNTY:
INFORMATION FORM (ALL APPLICANTS please answer questions 1 through 10)
YES
NO
1.
Are you a citizen of the United States?
2.
If you are a US citizen, would you like to register to vote? If registered, would you like to update your voter information?
By providing my electronic signature, I understand the personal information on my application form and my electronic signature will be used for submitting
my voter’s registration application to the Texas Secretary of State’s office. Wanting to register to vote, I authorize the Department of Public Safety to
transfer this information to the Texas Secretary of State.
3.
Do you wish to donate $1.00 to the Blindness Education Screening and Treatment Program?
4.
Do you want to support the Glenda Dawson Donate Life Texas donor registry? If yes, please indicate a donation amount of $1 or more $
.00
5.
Would you like to register as an organ donor?
6.
Do you want to support survivors of sexual assault? If yes, please indicate a donation amount of $1 or more $
.00 to help fund the testing
of sexual assault evidence collection kits (rape kits).
7.
Do you want to support Texas Veterans? If yes, please indicate your donation amount $
.00
8.
Do you have a health condition that may impede communication with a peace officer? If yes, please list
(physician must complete form DL-101 prior to the issuance of a DL/ID).
9.
a) Do you want a Veteran designator on your driver license or identification card? (proof of Honorable discharge required; acceptable documents
are DD214/5, NGB22, VA disability letter, proof of service/verification of honorable service card)
b) Are you a 60% disabled Veteran receiving compensation and want to waive the application fee? (see 9a for documents required)
10.
In the event of injury or death would you like to provide two (2) emergency contacts? If yes, please list:
a) Name
Telephone Number
Address
b) Name
Telephone Number
Address
For all Driver License Renewals complete MEDICAL questions 11 to 17. Answers to the questions below are for the confidential use of the Department.
11.
Do you currently have or have you ever been diagnosed with or treated for any medical condition that may affect your ability to safely operate a
motor vehicle?
Examples, including but not limited to: Diagnosis or treatment for heart trouble, stroke, hemorrhage or clots, high blood pressure, emphysema (within past two years)
progressive eye disorder or injury (i.e., glaucoma, macular degeneration, etc.) loss of normal use of hand, arm, foot or leg blackouts, seizures, loss of consciousness
or body control (within the past two years)
difficulty turning head from side to side
loss of muscular control
stiff joints or neck
inadequate hand/eye
coordination
medical condition that affects your judgment
dizziness or balance problems
missing limbs
If you answered YES above, has your condition
IMPROVED or
DETERIORATED since your last application for an original / renewal remake of your driver license?
12.
Do you have a mental condition that may affect your ability to safely operate a motor vehicle? If yes, please explain:
13.
Have you ever had an epileptic seizure, convulsion, loss of consciousness, or other seizure?
14.
Do you have diabetes requiring treatment by insulin?
15.
Do you have any alcohol or drug dependencies that may affect your ability to safely operate a motor vehicle or have you had any episodes
of alcohol or drug abuse within the past two years?
16.
Within the past two years, have you been treated for any other serious medical conditions?
Explain:
17.
Have you EVER been referred to the Texas Medical Advisory Board for Driver Licensing?
Any male United States citizen or immigrant who is at least 18 years of age but less than 26 years of age submitting this application consents to registration with the
United States Selective Service System. You must be registered to qualify for federal student aid (to include Pell grant), job training, federal employment, and citizenship
if an immigrant. In Texas, you must be registered to qualify for state college student aid or state employment. If convicted, failure to register with the Selective Service is
a felony punishable by up to five years in prison and/or a $250,000 fine. If not registered by age 26, you can no longer register and could permanently lose those benefits
associated with registration. For alternative options for applicants who object to conventional military service for religious or other conscientious reasons information is
available at: http://www.sss.gov/FactSheets/FSaltsvc.pdf.
I do solemnly swear, affirm, or certify that I am the person named herein and that the statements on this information form are true and correct. I further certify my resi-
dence address is a (check one): ( ) single family dwelling, ( ) apartment, ( ) motel, ( ) temporary shelter. I agree to immediately report to the Texas Department of
Public Safety any changes in my medical condition which may affect my ability to safely operate a motor vehicle.
DL-43 (Rev. 1/18)
SIGNATURE OF APPLICANT
DATE
(Replacement also called Duplicate)
APPLICATION FOR RENEWAL /REPLACEMENT/CHANGE
OF A TEXAS DRIVER LICENSE OR IDENTIFICATION CARD
DL or ID NUMBER
APPLICANT INFORMATION
CONTACT INFORMATION
LAST NAME:
HOME PHONE:
FIRST NAME:
OTHER PHONE:
MIDDLE NAME:
EMAIL:
SUFFIX:
ADDRESS INFORMATION
MAIDEN NAME:
RESIDENCE ADDRESS:
DATE OF BIRTH (mm/dd/yyyy):
CITY:
STATE:
SSN:
ZIP CODE:
COUNTY:
SEX: (Mark One)
MALE
FEMALE
WEIGHT: lbs.
MAILING ADDRESS:
EYE COLOR:
HEIGHT: ft.
in.
CITY:
STATE:
RACE/ETHNICITY:
(I) American Indian /Alaska Native
(A) Asian / Pacific Islander (B) Black (H) Hispanic (O) Other (W) White
ZIP CODE:
COUNTY:
INFORMATION FORM (ALL APPLICANTS please answer questions 1 through 10)
YES
NO
1.
Are you a citizen of the United States?
2.
If you are a US citizen, would you like to register to vote? If registered, would you like to update your voter information?
By providing my electronic signature, I understand the personal information on my application form and my electronic signature will be used for submitting
my voter’s registration application to the Texas Secretary of State’s office. Wanting to register to vote, I authorize the Department of Public Safety to
transfer this information to the Texas Secretary of State.
3.
Do you wish to donate $1.00 to the Blindness Education Screening and Treatment Program?
4.
Do you want to support the Glenda Dawson Donate Life Texas donor registry? If yes, please indicate a donation amount of $1 or more $
.00
5.
Would you like to register as an organ donor?
6.
Do you want to support survivors of sexual assault? If yes, please indicate a donation amount of $1 or more $
.00 to help fund the testing
of sexual assault evidence collection kits (rape kits).
7.
Do you want to support Texas Veterans? If yes, please indicate your donation amount $
.00
8.
Do you have a health condition that may impede communication with a peace officer? If yes, please list
(physician must complete form DL-101 prior to the issuance of a DL/ID).
9.
a) Do you want a Veteran designator on your driver license or identification card? (proof of Honorable discharge required; acceptable documents
are DD214/5, NGB22, VA disability letter, proof of service/verification of honorable service card)
b) Are you a 60% disabled Veteran receiving compensation and want to waive the application fee? (see 9a for documents required)
10.
In the event of injury or death would you like to provide two (2) emergency contacts? If yes, please list:
a) Name
Telephone Number
Address
b) Name
Telephone Number
Address
For all Driver License Renewals complete MEDICAL questions 11 to 17. Answers to the questions below are for the confidential use of the Department.
11.
Do you currently have or have you ever been diagnosed with or treated for any medical condition that may affect your ability to safely operate a
motor vehicle?
Examples, including but not limited to: Diagnosis or treatment for heart trouble, stroke, hemorrhage or clots, high blood pressure, emphysema (within past two years)
progressive eye disorder or injury (i.e., glaucoma, macular degeneration, etc.) loss of normal use of hand, arm, foot or leg blackouts, seizures, loss of consciousness
or body control (within the past two years)
difficulty turning head from side to side
loss of muscular control
stiff joints or neck
inadequate hand/eye
coordination
medical condition that affects your judgment
dizziness or balance problems
missing limbs
If you answered YES above, has your condition
IMPROVED or
DETERIORATED since your last application for an original / renewal remake of your driver license?
12.
Do you have a mental condition that may affect your ability to safely operate a motor vehicle? If yes, please explain:
13.
Have you ever had an epileptic seizure, convulsion, loss of consciousness, or other seizure?
14.
Do you have diabetes requiring treatment by insulin?
15.
Do you have any alcohol or drug dependencies that may affect your ability to safely operate a motor vehicle or have you had any episodes
of alcohol or drug abuse within the past two years?
16.
Within the past two years, have you been treated for any other serious medical conditions?
Explain:
17.
Have you EVER been referred to the Texas Medical Advisory Board for Driver Licensing?
Any male United States citizen or immigrant who is at least 18 years of age but less than 26 years of age submitting this application consents to registration with the
United States Selective Service System. You must be registered to qualify for federal student aid (to include Pell grant), job training, federal employment, and citizenship
if an immigrant. In Texas, you must be registered to qualify for state college student aid or state employment. If convicted, failure to register with the Selective Service is
a felony punishable by up to five years in prison and/or a $250,000 fine. If not registered by age 26, you can no longer register and could permanently lose those benefits
associated with registration. For alternative options for applicants who object to conventional military service for religious or other conscientious reasons information is
available at: http://www.sss.gov/FactSheets/FSaltsvc.pdf.
I do solemnly swear, affirm, or certify that I am the person named herein and that the statements on this information form are true and correct. I further certify my resi-
dence address is a (check one): ( ) single family dwelling, ( ) apartment, ( ) motel, ( ) temporary shelter. I agree to immediately report to the Texas Department of
Public Safety any changes in my medical condition which may affect my ability to safely operate a motor vehicle.
DL-43 (Rev. 1/18)
SIGNATURE OF APPLICANT
DATE
SOLICITUD PARA RENOVAR, REEMPLAZAR, Ó HACER
(El reemplazo también es llamado duplicado)
CAMBIOS EN LA LICENCIA DE CONDUCIR O TARJETA DE
NUMERO DE LICENCIA O DE TARJETA DE IDENTIFICACIÓN:
IDENTIFICACIÓN DEL ESTADO DE TEXAS
INFORMACIÓN DEL SOLICITANTE
INFORMACIÓN DE CONTACTO
APELLIDO:
NÚMERO DE TELÉFONO:
TELÉFONO SECUNDARIO:
PRIMER NOMBRE:
CORREO ELECTRÓNICO:
SEGUNDO NOMBRE:
SU DOMICILIO
SUFIJO:
DOMICILIO DONDE RESIDE:
APELLIDO DE SOLTERA:
CIUDAD:
ESTADO:
FECHA DE NACIMIENTO (mm/dd/aaaa):
CÓDIGO POSTAL:
CONDADO:
NÚMERO DE SEGURO SOCIAL:
SEXO: (Marque uno)
HOMBRE
MUJER
PESO: en libres.
DOMICILIO POSTAL (Lugar donde recibe su correspondencia):
COLOR DE LOS OJOS:
ESTATURA: pies
pulg.
RAZA/ETNIA:
(I) Amerindio/Nativo de Alaska (A) Asiático/nativo
CIUDAD:
ESTADO:
de las Islas del Pacífico (B) Negro (H) Hispano (O) Otro (W) Blanco
CÓDIGO POSTAL:
CONDADO:
INFORMACIÓN SOBRE EL SOLICITANTE (TODOS LOS SOLICITANTES favor de contestar las preguntas 1 a 10)
SI
NO
1.
¿Es usted ciudadano de los Estados Unidos?
2.
Si usted es ciudadano de los Estados Unidos, ¿le gustaría registrarse para votar? Si ya está registrado, ¿le gustaría actualizar su información de votante?
Al proporcionar mi firma electrónica, comprendo que la información personal en mi solicitud, junto con mi firma electrónica, se usará para enviar mi
solicitud de registro electoral a la oficina de la Secretaría del Estado de Texas. Deseo registrarme para votar; por lo tanto, autorizo al Departamento
de Seguridad Pública para transferir esta información a la Secretaría del Estado de Texas.
3.
¿Desea usted donar $1.00 al Programa de Educación, Evaluación y Tratamiento de la Ceguera?
4.
¿Desea apoyar el Programa de Registro de Texas-Glenda Dawson Donar Vida? En caso afirmativo, indicar una cantidad de la donación
de $1 o más $
.00
5.
¿Desea registrarse como donador de órganos?
6.
¿Quieres apoyar a los sobrevivientes de asalto sexual? Si es así, porfavor indique la cantidad de donación de $1 o más $
.00 para
ayudar a financiar la recopilación de evidencia de asalto sexual (kit de violación)
7.
¿Desea apoyar los Veteranos de Texas? Si la respuesta es sí, por favor, indique la cantidad de su donación $
.00
8.
¿Tiene usted alguna afección médica que le pueda impedir la comunicación con un oficial de la policía? En caso afirmativo, por favor indique
(el médico debe llenar el formulario DL-101 antes de emitir una licencia de conducir o tarjeta de identificación).
9.
a) Desea una insignia de Veterano en su licencia de conducir o su tarjeta de identificación? (Se requiere comprobante de baja honorable; los
documentos aceptables son DD214/5, NGB22, carta de discapacidad del VA, prueba de servicio/verificación de la tarjeta de servicio honorable)
b) ¿Es usted un Veterano que recibe 60% de compensación por discapacidad y desea quedar exento de los derechos de solicitud?
(vea el punto 9a para conocer qué documentos se requieren).
10.
En caso de sufrir lesiones o la muerte, ¿le gustaría proporcionar dos (2) contactos para emergencias? En caso afirmativo, por favor indique:
a) Nombre
Número telefónico
Domicilio
b) Nombre
Número telefónico
Domicilio
Para todas las Renovaciones de Licencia de Conducir, complete las preguntas MÉDICAS 11 a 17.
Las respuestas a las siguientes preguntas son para uso confidencial del Departamento.
11.
¿Tiene actualmente o alguna vez ha sido diagnosticado con o tratado por alguna enfermedad que pueda afectar su capacidad de
operar un vehículo motorizado de manera segura?
Ejemplos, incluyendo pero no limitado a: Diagnóstico o tratamiento por problemas cardíacos, derrame cerebral, hemorragia o coágulos, presión arterial alta, enfisema (en los últi-
mos dos años)
enfermedad progresiva o lesión de la vista (como glaucoma, degeneración macular, etc.)
pérdida del uso normal de la mano, brazo, pie o pierna
desvanec-
imientos, ataques, pérdida de la consciencia o control del cuerpo (en los últimos dos años)
dificultad para voltear la cabeza de un lado a otro
pérdida de control muscular
artic-
ulaciones o cuello rígidos
coordinación inadecuada de mano/ojo
afección médica que altere su juicio
mareos o problemas de equilibrio
pérdida de algún miembro
Si respondió SÍ a la pregunta anterior, ¿su afección ha
MEJORADO o
EMPEORADO desde su última solicitud de original/renovación de licencia de conducir?
12.
¿Tiene usted un condición mental que puede afectar su capacidad para operar con seguridad un vehículo motorizado? Si su respuesta es si,
por favor de explicar:
13.
¿Alguna vez ha tenido un ataque epiléptico, convulsión, pérdida de la consciencia u otro ataque?
14.
¿Tiene diabetes que requiera tratamiento con insulina?
15.
¿Tiene alguna dependencia del alcohol o de drogas que pudiera afectar su capacidad de operar un vehículo motorizado de manera
segura o ha tenido algún episodio de abuso de drogas o alcohol en los últimos dos años?
16.
En los últimos dos años, ¿ha recibido tratamiento por alguna otra afección médica grave?
Explique:
17.
¿Alguna vez ha sido remitido al Comité Asesor Médico de Licencias de Conducir de Texas?
Cualquier hombre ciudadano o inmigrante de los Estados Unidos entre 18 y 26 años de edad que presente esta solicitud otorga su consentimiento para ser registrado
en el Sistema de Servicio Militar Selectivo de los Estados Unidos. Usted debe estar registrado para tener derecho a recibir ayuda federal estudiantil (incluso la beca
Pell Grant), capacitación laboral, empleo federal y la ciudadanía si es inmigrante,. En Texas, usted debe estar registrado para tener derecho a recibir ayuda estudiantil
universitaria o empleo con el Estado. No registrarse en el Servicio Militar Selectivo es un delito mayor. Si es declarado culpable de ello, podría ser castigado hasta con
cinco años de prisión y/o una multa de 250,000 dólares. Si no se ha registrado antes de cumplir 26 años, ya no se podrá registrar y podría perder permanentemente los
beneficios asociados con el registro. Para conocer otras opciones alternativas para solicitantes que se oponen al servicio militar convencional por motivos religiosos u otros
motivos de conciencia, podrá encontrar información disponible en: http://www.sss.gov/FactSheets/FSaltsvc.pdf.
Juro solemnemente, afirmo o certifico que soy la persona que se indica en el presente documento y que las declaraciones en esta solicitud son verdaderas y correctas. Además
certifico que mi domicilio de residencia es (marque una opción): ( ) casa residencial, ( ) apartamento, ( ) hotel, ( ) sitio de refugio temporal. Estoy de acuerdo en informar
inmediatamente al Departamento de Seguridad Pública de Texas cualquier cambio en mi condición médica que pueda afectar mi capacidad para conducir de manera segura
un vehículo motorizado.
DL-43 (Rev. 1/18)
FIRMA DEL ASPIRANTE
FECHA
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