LOST, STOLEN OR DEFACED DRIVING LICENCE - DECLARATION
Please write clearly in BLACK CAPITAL letters.
1. Name and Address:
Surname
Title
Forenames
Date of birth
Address
Parish
Post Code
Telephone
E-mail
2. Please read the following section(s) and sign the declaration below:
I declare that I am applying for a duplicate driving licence because my original full/provisional driving licence
has been ………………………………….... (insert reason: defaced, lost, stolen).
I understand that if granted a duplicate licence, I will notify the Issuing Jersey Licensing Authority should my
original driving licence be found, or its whereabouts become known to me. I also will undertake to take all
reasonable steps to ensure its return to the Issuing Jersey Licensing Authority.
I further declare that:a) I do not already hold a driving licence issued by the Driver Licensing Authority of any country
listed in the Fifth Schedule of the Motor Vehicles (Driving Licences)(Jersey) Order 2003 (this
includes the United Kingdom and European countries);
and that
b) I have not submitted my Jersey driving licence to any Driver Licensing Authority for the purpose
of applying for a driving licence from that country.
I understand that under Article 18(2) of the Road Traffic (Jersey) Law 1956 it is an offence punishable by a
fine of up to £1000 to make a false statement or withhold any information for the purpose of obtaining a
driving licence.
Signature of licensee
Date
Parish Hall contact details:
The Connétable,
St Brelade’s Parish Hall,
St Brelade JE3 8BS
T: 741141
E: [email protected]
The Connétable,
St John’s Parish Hall,
St John JE3 4EJ
T: 861999
E: [email protected]
The Connétable,
St Ouën’s Parish Hall,
St Ouën JE3 2HY
T: 481619
E: [email protected]
The Connétable,
St Clement’s Parish Hall,
St Clement JE2 6FP
T: 854724
E: [email protected]
The Connétable,
St Lawrence Parish Hall,
St Lawrence JE3 1NG
T: 861672
E: [email protected]
The Connétable,
St Peter’s Parish Hall,
St Peter JE3 7AH
T: 481236
E: [email protected]
The Connétable,
Grouville Parish Hall,
Grouville JE3 9GA
T: 852225
E: [email protected]
The Connétable,
St Martin’s Public Hall,
St Martin JE3 6HW
T: 853951
E: [email protected]
The Connétable,
St Saviour’s Parish Hall,
St Saviour JE2 7LF
T: 735864
E: [email protected]
The Connétable,
The Town Hall, P O Box 50,
St Helier JE4 8PA
T: 811811
E: [email protected]
The Connétable,
St Mary’s Parish Hall,
St Mary JE3 3AS
T: 482700
E: [email protected]
The Connétable,
Trinity Parish Hall,
Trinity JE3 5JB
T: 865345
E: [email protected]