Arkansas Code Title 27. Transportation § 27-23-110. Application for commercial driver license

(A) The full name and current residential address of the applicant;

(B) A physical description of the applicant, including the applicant's sex, height, weight, eye color, and hair color;

(C) The applicant's date of birth;

(D) The applicant’s Social Security number;

(E) The applicant's signature;

(F) A consent to release driving record information;

(G) Certifications, including without limitation those required by 49 C.F.R. § 383.71, as in effect on January 1, 2013;

(H) Certification that the applicant is not subject to any disqualification under 49 C.F.R. § 383.51, as in effect on January 1, 2013, or any license suspension, revocation, or cancellation under state law and that the applicant does not have a driver license from more than one (1) state or jurisdiction;

(I) Certification that the applicant is or expects to be one (1) of the following types of drivers:

(J) For an applicant for a commercial driver license only, the surrender of the applicant's noncommercial driver licenses to the state;

(K) The names of all states in which the applicant has previously been licensed to drive any type of motor vehicle during the previous ten (10) years;

(L) For an applicant that certifies as nonexcepted interstate or nonexcepted intrastate, the applicant shall provide the Office of Driver Services with a medical examiner's certificate and any waiver, exemption, or skills performance evaluation certificate required by the medical examiner's certificate as provided in § 27-23-129; and

(M) Any other information required by the Office of Driver Services.