Form Hsmv 71143 PDF Details

Form Hsmv 71143 is a form provided by the Florida Department of Highway Safety and Motor Vehicles for individuals requesting information about their driving record. The form can be used to request driver history information, such as collisions, suspensions, and points on your license. It's important to keep track of your driving history to ensure that you maintain a clean record and stay safe on the road. Requesting a copy of your driving record can help you do just that. If you have any questions about Form Hsmv 71143 or need assistance filling it out, please contact the Florida Department of Highway Safety and Motor Vehicles. Thank you for your interest in keeping yourself and others safe on Florida roads!

QuestionAnswer
Form NameForm Hsmv 71143
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesonline create experiencecertificate, certification of minor driving experience form, driving experience certificate, certificte for driver

Form Preview Example

STATE OF FLORIDA

DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES

CERTIFICATION OF DRIVING EXPERIENCE OF A MINOR

I do hereby certify that ___________________________________________________________ , a minor,

FirstMiddleLast

date of birth _________________________, has driven a minimum of 50 hours during the past 12 months, of

which 10 hours of driving were at night per Section 322.05(3), Florida Statutes.

____________________________________

__________________________________

Signature of Parent, Legal Guardian or

Print Name

Responsible Adult

 

STATE OF FLORIDA

COUNTY OF ______________________

Sworn to (or affirmed) and subscribed before me this ________day of ___________, 20______,

by ___________________________________ who is personally known to me or produced identification.

_____________________________________________________ as proof of identification.

(Identification type and number)

_____________________________________________________

Notary Public or DL Examiner-Signature

_____________________________________________________

Print, Type, or Stamp Commissioned Name of Notary Public

INSTRUCTIONS:

1.One parent, legal guardian, or other responsible adult 21 years old or older must sign this form.

2.All signatures must be notarized or witnessed by an examiner.

HSMV 71143 (Rev 01/11)

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1. The driving experince certified will require certain details to be inserted. Be sure that the subsequent blank fields are filled out:

Completing section 1 of certificate of driving experience

2. Once the first part is filled out, proceed to type in the suitable information in all these: Sworn to or affirmed and, by who is personally known to me, as proof of identification, Notary Public or DL, Print Type or Stamp Commissioned, and INSTRUCTIONS One parent legal.

Best ways to fill in certificate of driving experience portion 2

Always be very careful while completing Notary Public or DL and Print Type or Stamp Commissioned, because this is the part in which a lot of people make mistakes.

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