Form DS-516 Certificate of Eligibility for Veterans Driver's License/Identification Card - Georgia

Form ds-516 or the "Certificate Of Eligibility For Veterans Driver's License/identification Card" is a form issued by the Georgia Department of Driver Services.

Download a PDF version of the Form ds-516 down below or find it on the Georgia Department of Driver Services Forms website.

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CERTIFICATE OF ELIGIBILITY FOR VETERANS DRIVER'S LICENSE/IDENTIFICATION CARD
INSTRUCTIONS:
This application is for a Veteran or Disabled Veteran Driver’s License or State of Georgia Identification Card as provided
for in Chapter 5 of Title 40 of the Official Code of Georgia Annotated.
PART I: Veteran and/or spouse must complete and sign it in the presence of a representative of the Georgia Department
of Veterans Service (GDVS).
PART II: To be completed by GDVS.
Official records must be presented to support residency and service claims.
Take completed form to the Department of Driver Services (DDS) Customer Service Center. In addition to identification
verification, DDS may review the documentation presented to GDVS in obtaining the certification.
PART I
Check the appropriate box
:
I am a veteran and have been a resident of the State of
I am the lawful spouse of the disabled veteran identified
below.
Georgia for 2 or more consecutive years prior to the date of
I am the surviving spouse of a deceased veteran and I have
this application.
not remarried.
I am a disabled veteran and have been a resident of the State
Prior to death, the identified deceased veteran was a resident
of Georgia for 2 or more consecutive years prior to the date of
of the State of Georgia for 2 or more consecutive years prior
this application.
to the date of this application.
Applicant
Deceased or Disabled Veteran’s Information
First Name
Middle
Last Name
First Name
Middle
Last Name
Current Address: (Street)
(City)
(State)
(Zip)
Date of Birth (mm/dd/yy)
State of Birth
Current GA Driver’s License No.
SSN#
Date of Death (mm/dd/yy)
Date of Birth (mm/dd/yy)
State of Birth
Current GA Driver’s License No.
SSN#
SVC#
Active Duty Start Date
Separation Date
SVC#
Active Duty Start Date
Separation Date
Branch of Service
Type of Discharge
Branch of Service
Type of Discharge
Legal Residence at Time of Entry on Active Duty:
Legal Residence At Time of Entry On Active Duty:
)
)
(Street)
(City)
(State)
(Zip
(Street)
(City)
(State)
(Zip
PART II
CERTIFICATION: The information in PART I has been verified from the following official records:
Supporting Document
Dates of Residence
From
To
Supporting Document
Dates of Residence
From
To
Active duty includes wartime service
Yes (Free DL/ID Card)
No (Normal DL/ID Fee Applies)
“I certify the information provided by me on this application is
“This is to certify the applicant meets the requirements to
true and correct.”
qualify for the Veterans Driver's License as provided for in
Chapter 5 of Title 40 of the Official Code of Georgia
Applicant’s Signature: _________________________________
Annotated.”
____________________________, Commissioner, GDVS
Date: _____________________
By______________________________________
(Name of GDVS Representative)
State and federal law provide severe penalties, to include fines,
Office Address ____________________________________
imprisonment, or both, for the willful submission of any false
_____________________________________
statement or evidence of a material fact.
Date: ______________
DS-516 (10/16/14) (Previous versions are obsolete and may not be used.)
CERTIFICATE OF ELIGIBILITY FOR VETERANS DRIVER'S LICENSE/IDENTIFICATION CARD
INSTRUCTIONS:
This application is for a Veteran or Disabled Veteran Driver’s License or State of Georgia Identification Card as provided
for in Chapter 5 of Title 40 of the Official Code of Georgia Annotated.
PART I: Veteran and/or spouse must complete and sign it in the presence of a representative of the Georgia Department
of Veterans Service (GDVS).
PART II: To be completed by GDVS.
Official records must be presented to support residency and service claims.
Take completed form to the Department of Driver Services (DDS) Customer Service Center. In addition to identification
verification, DDS may review the documentation presented to GDVS in obtaining the certification.
PART I
Check the appropriate box
:
I am a veteran and have been a resident of the State of
I am the lawful spouse of the disabled veteran identified
below.
Georgia for 2 or more consecutive years prior to the date of
I am the surviving spouse of a deceased veteran and I have
this application.
not remarried.
I am a disabled veteran and have been a resident of the State
Prior to death, the identified deceased veteran was a resident
of Georgia for 2 or more consecutive years prior to the date of
of the State of Georgia for 2 or more consecutive years prior
this application.
to the date of this application.
Applicant
Deceased or Disabled Veteran’s Information
First Name
Middle
Last Name
First Name
Middle
Last Name
Current Address: (Street)
(City)
(State)
(Zip)
Date of Birth (mm/dd/yy)
State of Birth
Current GA Driver’s License No.
SSN#
Date of Death (mm/dd/yy)
Date of Birth (mm/dd/yy)
State of Birth
Current GA Driver’s License No.
SSN#
SVC#
Active Duty Start Date
Separation Date
SVC#
Active Duty Start Date
Separation Date
Branch of Service
Type of Discharge
Branch of Service
Type of Discharge
Legal Residence at Time of Entry on Active Duty:
Legal Residence At Time of Entry On Active Duty:
)
)
(Street)
(City)
(State)
(Zip
(Street)
(City)
(State)
(Zip
PART II
CERTIFICATION: The information in PART I has been verified from the following official records:
Supporting Document
Dates of Residence
From
To
Supporting Document
Dates of Residence
From
To
Active duty includes wartime service
Yes (Free DL/ID Card)
No (Normal DL/ID Fee Applies)
“I certify the information provided by me on this application is
“This is to certify the applicant meets the requirements to
true and correct.”
qualify for the Veterans Driver's License as provided for in
Chapter 5 of Title 40 of the Official Code of Georgia
Applicant’s Signature: _________________________________
Annotated.”
____________________________, Commissioner, GDVS
Date: _____________________
By______________________________________
(Name of GDVS Representative)
State and federal law provide severe penalties, to include fines,
Office Address ____________________________________
imprisonment, or both, for the willful submission of any false
_____________________________________
statement or evidence of a material fact.
Date: ______________
DS-516 (10/16/14) (Previous versions are obsolete and may not be used.)

Download Form DS-516 Certificate of Eligibility for Veterans Driver's License/Identification Card - Georgia

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