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The form specifies when a medical certificate and affidavit must be submitted for Categories 1–4, including special cases such as federal exemptions, passenger endorsements, and certain limited operations, then provides signature and date fields.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/cdl-holder-self-certification-new-jersey-motor-vehicle-commission-medical-certificate-affidavit/299524/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/cdl-holder-self-certification-new-jersey-motor-vehicle-commission-medical-certificate-affidavit/299524.png","ImageObject",300,407,{"name":42,"@type":43},"Eden","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-22","2026-09-18",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",15,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What does the New Jersey CDL Holder Self-Certification require you to do?","Question",{"text":63,"@type":64},"You must provide the driver’s name and information, circle whether you are submitting a copy of your medical certificate, and select the self-certification category that applies to your operations.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"When must a medical certificate and affidavit be submitted for Category 1?",{"text":68,"@type":64},"Category 1 covers interstate operations subject to 49 C.F.R. part 391; it requires submission of the medical certificate and affidavit. The form notes additional groups (such as drivers not in other categories, and those with certain federal vision or diabetes exemptions).",{"name":70,"@type":61,"acceptedAnswer":71},"Are passenger endorsement holders required to submit a medical certificate?",{"text":72,"@type":64},"Yes. The form states that all P (passenger) endorsement holders, including government workers, must submit a valid medical certificate to maintain the P endorsement on their CDL.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},299524,1790042033,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":22,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":30},1374391974468,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","New Jersey  \nMotor Vehicle Commission  \nCDL Holder Self-Certification  \nName of Driver:   New Jersey Driver License Number:    \nAre you submitting a copy of your medical certificate? YES NO (please circle yes or no)  \nNote: Only Class A, B, or C drivers that check the box for category 1 or 3 self-certification below must submit a copy of their medical certificate; however all CDL holders, Class A, B, or C drivers must submit this affidavit.  \nPlease check only one of the following Self-Certification categories that apply to you.  \nI certify my commercial transportation is:  \nCategory 1: Interstate and subject to 49 C.F.R. part 391. (Medical certificate and affidavit must be submitted)  \n• All Class A, B, and C drivers who do NOT fall under any of the other categories.  \n• All Class A, B, and C drivers granted a federal vision or diabetes exemption; or SPE-limb impairment Skill Performance Evaluation.  \nCategory 2: Interstate but operating exclusively in transportation or operations excepted under 49 C.F.R.  \n390.3(f), 391.2, or 391.68 (Affidavit must be submitted) .  \n• Transportation performed by the federal government, a state, or any political subdivision of a state.  \n(Note: The Motor Vehicle Commission requires ALL P (passenger) endorsement holders, including government workers, to submit a valid medical certificate in order to maintain the P endorsement on  \ntheir CDL. N.J.A.C. 13:21-14.5(c) (6)  \n• The transportation of human corpses or sick and injured persons.  \n• The operation of fire trucks and rescue vehicles while involved in emergency and related operations.  \n• Apiarian industries (Beekeepers) .  \n• Farm vehicle drivers operating within a 150 mile radius of the farm.  \nCategory 3: Intrastate and subject to state driver qualification requirements. (Medical certificate and affidavit must be submitted).  \n• All Class A, B, and C drivers who do NOT fall under any of the other categories.  \nCategory 4: Intrastate, but operating exclusively in transportation or operations excepted from all or part of the state driver qualification requirements. (Affidavit must be submitted) .  \n• Transportation performed by the federal government, a state, or any political subdivision of a state.  \n(Note: The Motor Vehicle Commission requires ALL P (passenger) endorsement holders, including government workers, to submit a valid medical certificate in order to maintain the P endorsement on  \ntheir CDL. N.J.A.C. 13:21-14.5(c) (6)  \n• The transportation of human corpses or sick and injured persons.  \n• The operation of fire trucks and rescue vehicles while involved in emergency and related operations.  \n• Apiarian industries (Beekeepers) .  \n• Farm vehicle drivers operating within a 150 mile radius of the farm.  \nDriver’s Signature Date  \nNew Jersey Motor Vehicle Commission  \nCDL/Bus Unit PO Box 685 Trenton, NJ 08666  \nOn the Road to Excellence Visit [us at www.njmvc.gov](us at www.njmvc.gov)[ ](us at www.njmvc.gov)New Jersey is an Equal Opportunity Employer","cbCaic73FICbRY8C","https://ap.wps.com/l/cbCaic73FICbRY8C","pdf",202968,"English","# CDL Holder Self-Certification\n## Driver information and yes/no submission\n## Self-certification categories (1-4)\n## Signature and date","[{\"question\":\"What does the New Jersey CDL Holder Self-Certification require you to do?\",\"answer\":\"You must provide the driver’s name and information, circle whether you are submitting a copy of your medical certificate, and select the self-certification category that applies to your operations.\"},{\"question\":\"When must a medical certificate and affidavit be submitted for Category 1?\",\"answer\":\"Category 1 covers interstate operations subject to 49 C.F.R. part 391; it requires submission of the medical certificate and affidavit. The form notes additional groups (such as drivers not in other categories, and those with certain federal vision or diabetes exemptions).\"},{\"question\":\"Are passenger endorsement holders required to submit a medical certificate?\",\"answer\":\"Yes. The form states that all P (passenger) endorsement holders, including government workers, must submit a valid medical certificate to maintain the P endorsement on their CDL.\"}]","CDL Holder Self-Certification - New Jersey Motor Vehicle Commission - Medical Certificate Affidavit | PDF",1789769813]