Commercial Driver License Self-Certification Affidavit - Texas
CDL-7 (00-0112)
Texas Commercial Driver License
Self-Certification Affidavit
Federal Regulations along with the State of Texas Administrative Rules require a commercial driver to
certify in one of the 4 categories listed below to determine if a medical certificate is required. If you
select category one (1) or three (3), you must present a valid medical certificate.
Last Name First Name Middle Name Maiden Name
Driver License Number Birth Date Social Security Number
I certify my commercial transportation is:
Category 1. Non-excepted Interstate. I operate or expect to operate in interstate commerce, am
both subject to and meet the qualification requirements under 49 CFR part 391, and am required to
obtain a medical examiner's certificate by § 391.45.(CDL-4, CDL-10 box 7, medical certificate is required)
Category 2. Excepted Interstate. I operate or expect to operate in interstate commerce, but
engage exclusively in transportation or operations excepted under 49 CFR 390.3(f), 391.2, 391.68 or
398.3 from all or parts of the qualification requirements of 49 CFR part 391. (CDL-10)
Category 3. Non-Excepted Intrastate. I operate or expect to operate in intrastate commerce, and
am subject to the physical qualifications of 49 CFR Part 391. (CDL-5 part b, medical certificate is required)
Category 4. Excepted Intrastate. I operate or expect to operate in intrastate commerce, and
engage exclusively in transportation or operations that exempt me from meeting the medical standards
of 49 CFR Part 391. (CDL-5 part a, CDL-10 box 10 or box 11)
I certify that I have read, understand and meet the above checked categories for a commercial driver
license.
__________________________________ _______________________
Signature Date
Please email, fax, or mail the medical certificate (if applicable) and the Self-Certification affidavit to:
Email (pdf format only):
CDLMedCer[email protected]s.texas.gov
Fax: 512-424-2002
Mail: Texas Department of Public Safety
Enforcement & Compliance Service
Attention: CDL Section
P.O. Box 4087
Austin, Texas 78773
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