New License Application

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– Step 1 of 3

Name *

First

Middle

Last

Upload Phone if

Gender *

Male
Female

Date Born *

Birth Certificate Registration Number: *

Phone *

Email *

Residential Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Postal Address- if different to above

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

License Application for: *

Motorbike- Learner
Motorbike
Car- Learner
Car- P (red) Manual
Car- P (red)
Car- P (green)
Car- Open

I hereby confirm; *

I have no medical conditions that may affect my ability to drive safely
I have medical conditions that may affect my ability to drive safely, and I have included relevant Medical evidence
I require prescription glasses to drive
I am restricted to an automatic transmission only
I am restricted to daylight driving conditions only

tick all that apply

Medical File Upload

Drag & Drop Files, Choose Files to Upload You can upload up to 2 files.

I hereby confirm; *

I agree to donate my organs in the event of an accident and my next of kin is aware
I do not agree to donate my organs in the event of an accident and my next of kin is aware

ID Photograph *

Camera Preview

Disclaimer: Use a bright lit area with a blank/solid background Any and all incomplete images will not be accepted and you may not be refunded your application fee

License Term *

Shipping *

Australia
International- no tracking
International-with tracking

Signature *

Clear Signature

Applicant Declaration *

I, the applicant, do hereby confirm that the details as provided in this application are true and correct to the best of my ability and consent to the Crown Licensing Regulatory Authority verifying my information and using my private information contained herein and existing on the Crown Licensing Regulatory Authority database, including but not limited to my digital photograph and autograph and consent for the Crown Licensing Regulatory Authority to conduct enquires necessary to assess this application for the purposes associated with approval of this application, including but not limited to criminal and driving history checks
I, the applicant, understand that by providing any false or misleading information to the Crown Licensing Regulatory Authority may result in this application being refused and if applicable the cancellation of the International Driver license
I, the applicant, understand the responsibilities of holding an International Driver License and will comply with requirements under the International Crown Licensing Regulatory Authority, as found under the Legal Compliance section
I, the applicant, do hereby confirm that I have not had a driver’s license, held by the International Crown Licensing Regulatory Authority or any other licensing agency and/or court, previously or currently suspended, cancelled or restricted due to a serious at fault vehicle accident
I, the applicant, understand that the International Crown Licensing Regulatory Authority is not a govenment agency and that I have read and understand the legal policy

**LEGAL DISCLAIMER – LIMITATION OF RESPONSIBILITY FOR LICENSE HOLDERS**

**International Crown Licensing Regulatory Authority (ICLRA)**

This disclaimer defines the relationship between the International Crown Licensing Regulatory Authority (“ICLRA”) and individuals or entities who obtain licenses, and/or registrations issued by ICLRA (“License Holders”).

1. Independent Status of License Holders

All License Holders operate as independent people or entities.
Nothing contained in any license, certificate, or registration issued by ICLRA shall be interpreted as creating:

* an agency relationship
* a partnership
* an employment relationship
* a joint venture
* or any representation authority

between ICLRA and the License Holder.

2. No Operational Control

ICLRA, as a new incoming licensing and registration authority, does not control, supervise, or direct the activities, services, business practices, or conduct of License Holders.
All operational decisions and actions are undertaken solely by the License Holder.

3. Assumption of Responsibility

Each License Holder accepts full responsibility for:

* their professional activities
* business operations
* representations made to third parties
* compliance with applicable laws and regulations in their jurisdiction.

ICLRA bears no responsibility for the acts, omissions, or representations of License Holders.

4. No Guarantee or Endorsement

Issuance of an ICLRA license or registration does not constitute a guarantee, warranty, endorsement, or certification of competence, legality, or regulatory compliance of the License Holder within federal or state jurisdictions that fall outside the Crown jurisdiction.

5. Limitation of Liability

To the maximum extent permitted by law, ICLRA shall not be liable for any loss, damage, claim, liability, or expense arising from or related to:

* actions or omissions of License Holders
* reliance upon licenses or certifications issued by ICLRA
* services, products, or activities conducted by License Holders.

6. Indemnification

License Holders agree to indemnify and hold harmless ICLRA, its officers, administrators, and representatives from any claims, damages, liabilities, or legal proceedings arising from the License Holder’s activities, conduct, and/or representations.

7. Non-Excludable Rights

Nothing in this disclaimer shall exclude or limit liability where such exclusion is prohibited by applicable law under Crown jurisdiction.

8. Acceptance

By accepting, using, or representing possession of an ICLRA license, certification, or registration, the License Holder acknowledges and agrees to the terms of this disclaimer.

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