Certification For Waiver Of Skill Test For Military Personnel printable pdf download

Certification For Waiver Of Skill Test For Military Personnel

State of Florida

Department of Highway Safety and Motor Vehicles

Division of Motorist Services

Certification for Waiver of Skill Test for Military Personnel

This form is used by active duty military, guard, reservist, or military personnel who have separated from

service no more than 90 days before this application date. The form is to be completed by you and your

commanding officer and returned to the driver license office. If you do not meet all of the requirements listed,

you will be required to successfully pass the Commercial Driver License Skills Tests.

Applicant Information & Certification (Please initial compliance to each certification

requirements)

___________________________________ ___________________________ ___________________________________________

First Name

Middle Name

Last Name

_____________________________________

________________________________________________________________________________________

Date of Birth

Driver License Number

________For at least two years immediately preceding this application, I have operated a motor vehicle

representative of the Commercial Driver License classification I am applying to operate.

_______I have not had more than one license (except in the instances specified in § 383.21(b));

_______I have not had any license suspended, revoked, or canceled;

_______ I have not had any convictions for any type of motor vehicle for the disqualifying offenses contained in §

383.51(b);

_______ I have not had more than one conviction for any type of motor vehicle for serious traffic violations;

_______ I have not had any conviction for a violation of State or local law relating to motor vehicle traffic control

(other than a parking violation) arising in connection with any traffic accident, and have no record of an

accident in which I was at fault.”

I certify that the statements indicated by my initials are true and correct to the best of my knowledge.

___________________________________________________________

______________________________________________________

Signature

Date

Employer Certification

HSMV 71054 Rev 07/11

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Certification For Waiver Of Skill Test For Military Personnel