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BEL-FO-01011 - 
<Recto - identity>
<Recto - identity>

1 - surname of the holder

2 - other name(s) of the holder

3 - date and place of birth

4a - date of issue of the licence

4b - date of expiry of the licence

4c - name of the issuing authority

5 - licence number

6 - photograph of the holder

7 - signature of the holder

8 - permanent place of residence

9 - category(ies) of vehicle(s) the holder is entitled to drive

12 - additional information / restriction(s)

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[ Document generated on : 06.05.2022 11:00:26 CEST ]