Driver Licensing Online

Application Completion Form

Do it online at: www.direct.gov.uk/drivinglicence

Our Ref: Form D

Application Reference Number-20131171723710 Personal Details Send to :DVLA SWANSEA SA99 1YW
The Post Office Premium Checking Service can not be used for online transactions. Please return this form by post.

Title Surname Forename(s) Date of Birth

Mr sung simon 24/01/1975

Lost/stolen/defaced or destroyed driving licence

Thank you for using our online driving licence service. Before we can send you a driving licence please sign and date this form to declare that your driving licence is either lost, stolen, defaced or destroyed. Please sign below and return to the address given at the top of this form within 28 days. Signed : _____________________________________ Date : _______________________________________ If we do not receive this form within 28 days, your application for a driving licence will be deleted and any payment will be refunded. We will not issue a Driving Licence or update your Driver Record.

04/06a