Fill in Your 478 Alaska Form Access Document Now

Fill in Your 478 Alaska Form

The 478 Alaska form is the official application for obtaining a driver license, permit, or identification card in the state of Alaska. This form gathers essential personal information, including your legal name, date of birth, and residence address, while also allowing you to express preferences like organ donation and voter registration. Ready to take the next step? Fill out the form by clicking the button below.

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Overview

The 478 Alaska form serves as a comprehensive application for obtaining an Alaska driver license, permit, or identification card. This essential document encompasses various classifications, including non-commercial and commercial licenses, instruction permits, and identification cards. Individuals are prompted to provide personal details, such as their legal name, date of birth, physical characteristics, and contact information. Importantly, the form also addresses veteran status, allowing applicants to declare their military service and request a veteran designation on their license. Additionally, it includes options for organ donation and contributions to awareness funds, reflecting a commitment to community health. Voter registration is another significant aspect, where applicants can express their desire to register or update their voter information, ensuring their participation in the democratic process. The form also requires disclosure of any previous names and past driving privileges, including any suspensions or revocations. Medical questions are included to assess the applicant's ability to operate a vehicle safely. Lastly, the form concludes with a declaration of truthfulness, emphasizing the importance of accuracy in the application process. Each section is designed to gather vital information while promoting responsible citizenship and community involvement.

478 Alaska Example

STATE OF ALASKA

DIVISION OF MOTOR VEHICLES

APPLICATION FOR ALASKA DRIVER LICENSE,

PERMIT OR IDENTIFICATION CARD

478

LICENSE / PERMIT

 

 

CLASSIFICATION

 

 

 

ENDORSEMENTS

 

 

 

 

 

 

 

 

 

Driver License

 

Non-Commercial (D)

 

 

Hazardous

 

Passenger (P)

Instruction Permit

 

Motorcycle

 

 

Tank (N)

 

School Bus (S)

Identification Card

 

CDL

 A  B  C

 

 

Tank (N) + HazMat (H)

 

Doubles / Triples

FULL

 

First

 

 

Middle

 

 

 

Last

 

 

Suffix

LEGAL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AK license / permit / ID number, if applicable.

 

Date of Birth

 

Sex

 

 

Height

 

Weight

 

Hair Color

Eye Color

 

 

 

 

 

 

 

 

 

 

ft

in

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PLACE

 

City

 

 

 

State

 

Country (If other than USA)

 

Social Security Number

OF

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BIRTH:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mailing Address (This address will appear on the license, permit or ID.)

City

State

Zip Code

Residence Address (Physical location – no PO Box or Mail Receiving Station addresses.)

City

State

Zip Code

Email

Phone #

 

I declare myself an honorably discharged US Armed Forces veteran and authorize DMV to send my personal information to the

 YES

 NO

VETERAN

Dept. of Military and Veterans Affairs to provide benefits to me.

 

 

 

I have a US Armed Forces honorable discharge and wish to have a veteran designation placed / retained on my license.

 YES

 NO

ORGAN DONOR

Would you like to be an organ donor with a designator displayed on your license / ID card?

 YES

 NO

Would you like to donate $1 or more to the anatomical gift awareness fund? If so, how much?

$

 

 

 

 

Would you like to register to vote or make changes to your voter registration

 YES

 NO

 

 

 

 

Are you a U.S. Citizen? You may not register to vote if you are not a U.S. citizen.

 YES

 NO

 

 

 

 

Have been convicted of a felony?

 

 YES

 NO

 

 

 

 

VOTER

Have you been unconditionally discharged?

 

 YES

 NO

REGISTRATION

Would you like your residence address kept confidential? (Your residence address must be DIFFERENT than your mailing

 YES

 NO

 

address to be kept confidential.)

 

 

 

 

If you are already registered to vote in the State of Alaska, this form will update your voter registration address.

 

 

 

Do you want your address updated for voter registration purposes?

 YES

 NO

 

(In order to be a registered voter of Alaska, you must provide an Alaska residence address.)

 

 

PREVIOUS

List any previous / maiden names by which you have been known:

 

 

NAMES

 

 

 

 

 

 

 

 

List any States in which you have ever held a permit, license or id card:

 

 

 

Have your driving privileges ever been suspended or revoked or application for license refused?

 YES

 NO

DRIVER

State:

Date:

Reason:

 

 

LICENSE

 

 

State:

Date:

Reason:

 

 

QUESTIONS

 

 

Within the past 5 years, have you had a medical condition or impairment, mental or physical disorder, seizure, or any other

 YES

 NO

(You do not need to

health problems that could affect your ability to safely operate a motor vehicle?

answer these

 

 

 

 

 

 

 

questions for an ID

If yes, please explain:

 

 

 

 

card)

 

 

 

 

Within the last five years, have you had three or more alcohol or drug related convictions?

 YES

 NO

 

 

If yes, you must provide physician verification that the problem is under control or proof of completion of a rehabilitative treatment program

 

 

COMMERCIAL

Are you domiciled (permanent residence) in the State of Alaska?

 YES

 NO

DRIVERS ONLY

 

 

 

 

 

I acknowledge that receiving an Alaska Permit, License or ID card may cancel or invalidate any Permit, License or ID card from another state per the laws of that state. I have personally reviewed the information on this application and certify under penalty of perjury that to the best of my knowledge and belief the information on this application is true and correct. NOTE: Making a false statement in connection with this application may be punishable by a maximum penalty of $50,000 or five years imprisonment or both per AS 11.46.505.

X

Signature of Applicant (MUST SIGN IN FRONT OF A DMV REPRESENTATIVE)

Date

AMVC ID / Office Number

*****DMV USE ONLY *****

VISION

฀With CL

Left

Both

Right

Vision Notes

CDL Color Blind Test:

TEST

฀Without CL

20/

20/

20/

 

Pass / Fail / Medical Card

LICENSE

฀Orig ฀Renew ฀Duplicate

ISSUED

Class:

 

DOCUMENTS SEEN / OTHER NOTES

(Rev.08/14/2017)

Alaska.gov/dmv

Document Specifics

Fact Name Details
Form Purpose The 478 Alaska form is used to apply for a driver license, permit, or identification card in the state of Alaska.
Governing Law This form is governed by Alaska Statutes, specifically AS 11.46.505, which outlines penalties for false statements.
Eligibility Requirements Applicants must be U.S. citizens, residents of Alaska, and must disclose any previous driving suspensions or medical conditions affecting driving ability.
Voter Registration Option The form includes an option to register to vote or update voter registration information while applying for a driver license or ID.
Organ Donation Applicants can indicate their wish to be an organ donor and contribute to the anatomical gift awareness fund on the form.
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