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Indiana Department of Revenue Medical Examination Report for Commercial Driver Fitness Determination CDL-PHY State Form # 49867 (R3/10-04) Commercial Driver s License, Medical Section 5252 Decatur
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Begin by reading the instructions carefully to familiarize yourself with the application process.
02
Make sure you have all the necessary documents and information required for filling out the form.
03
Start by providing your personal details such as your full name, address, and contact information.
04
Fill in your CDL number and other relevant identification details accurately.
05
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Who needs CDL-PHY instructions 10-19-04 CDL-PHY?

01
Individuals who are applying for or renewing their Commercial Driver's License (CDL).
02
Truck drivers or individuals involved in the transportation industry who are required to hold a CDL.
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Anyone who needs to submit a CDL-PHY form as part of their licensing or employment requirements.
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CDL-PHY instructions 10-19-04 refer to the specific guidelines for conducting a commercial driver's license physical examination.
Commercial drivers who need to renew or obtain a commercial driver's license are required to file CDL-PHY instructions 10-19-04.
To fill out CDL-PHY instructions 10-19-04, a certified medical examiner must conduct a physical examination of the commercial driver and complete the required forms.
The purpose of CDL-PHY instructions 10-19-04 is to ensure that commercial drivers meet the physical qualifications required to safely operate commercial vehicles.
CDL-PHY instructions 10-19-04 must include details of the commercial driver's physical examination results, medical history, and any limitations or restrictions on driving.
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