Garda Declaration for
Lost/Stolen/Damaged Driving
Licence or Learner Permit
GARDA DECLARATION
If your licence/learner permit was lost, stolen or damaged please sign the declaration below and get it witnessed
and stamped at your local Garda station. Please note if you find or get your old licence/permit back after applying for
a replacement, the old licence/permit will no longer be valid
A scan of the completed declaration form can be uploaded when you are making your NDLS online application for
a replacement driving licence/learner permit or it can be emailed to [email protected]. Alternatively, the completed
declaration can be submitted by post to NDLS, PO BOX 858, Southside Delivery Office, Cork.
Please complete this form in
BLOCK CAPITAL LETTERS
Name:
Address:
Date of Birth:
PPSN:
I declare my licence/permit Lost
Stolen
Damaged
(tick as appropriate)
Signature of applicant
I certify that the applicant has declared their licence/permit lost/stolen/damaged
Name of garda
Signature of garda
GARDA DECLARATION
GARDA STATION STAMP
