Form 5285 - Skills Test Failure - Behind The Wheel Driver Training Log
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MISSOURI DEPARTMENT OF REVENUE
DRIVER LICENSE BUREAU
FORM
P.O. BOX 200
Telephone:
(573) 751-1887
5285
Fax:
(573) 522-8174
JEFFERSON CITY, MO 65105-0200
SKILLS TEST FAILURE - BEHIND THE WHEEL
DRIVER TRAINING LOG
REV (03-2010)
DRIVER’S NAME (PLEASE PRINT)
DRIVER’S PERMIT/LICENSE NUMBER
DRIVER’S DATE OF BIRTH
You may use this form to log your driver training. If additional sheet(s)
are necessary, you may make, or print, additional copies of this form.
Date
Start Time
End Time
Training Time
Instructor’s Name
Total Hours of Driver Training:___________
THE NAME, ADDRESS, AND DRIVER LICENSE NUMBER OF YOUR
INSTRUCTOR(S) MUST BE RECORDED ON THE REVERSE
SIDE OF THIS FORM.
EMAIL ALL INQUIRIES TO: dlbmail@dor.mo.gov
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Parent category: Financial