DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES
CERTIFICATION OF DRIVING EXPERIENCE OF A MINOR
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.
STATE OF FLORIDA
Sworn to (or affirmed) and subscribed before me this ____________day of ____________________, 20_______,
By ___________________________________ who is personally known to me
or produced identification