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DL-180C 7-08 PARENT OR GUARDIAN certification FORM D E PA R T M E N T O F T R A N S P O R TAT I O N print name of minor learner s permit number I hereby certify that this minor applicant has completed at least 50 hours of supervised practical driving experience. This behind-the-wheel experience was given by licensed Pennsylvania driver s 21 years of age or older. Sign in presence of Notary Driver License Examiner End-Of-Course Skill Test Teacher or Motorcycle Safety Instructor X signature of parent guardian person in loco parentis or spouse at least years of age print name as it appears in signature Notarized Signature required ONLY if not accompanying the teen driver to the Driver License Center for their Skills Test. Subscribed and Sworn to Before Me MO. DAY YEAR Signature of Person Administering Oath S E A L SIGN IN PRESENCE OF NOTARY or driver license examiner Exam Center examiner Instructor. This behind-the-wheel experience was given by licensed Pennsylvania driver s 21 years of age or older. Sign in presence of Notary Driver License Examiner End-Of-Course Skill Test Teacher or Motorcycle Safety Instructor X signature of parent guardian person in loco parentis or spouse at least years of age print name as it appears in signature Notarized Signature required ONLY if not accompanying the teen driver to the Driver License Center for their Skills Test. Sign in presence of Notary Driver License Examiner End-Of-Course Skill Test Teacher or Motorcycle Safety Instructor X signature of parent guardian person in loco parentis or spouse at least years of age print name as it appears in signature Notarized Signature required ONLY if not accompanying the teen driver to the Driver License Center for their Skills Test. Subscribed and Sworn to Before Me MO. DAY YEAR Signature of Person Administering Oath S E A L SIGN IN PRESENCE OF NOTARY or driver license examiner Exam Center examiner Instructor. This behind-the-wheel experience was given by licensed Pennsylvania driver s 21 years of age or older. Sign in presence of Notary Driver License Examiner End-Of-Course Skill Test Teacher or Motorcycle Safety Instructor X signature of parent guardian person in loco parentis or spouse at least years of age print name as it appears in signature Notarized Signature required ONLY if not accompanying the teen driver to the Driver License Center for their Skills Test. Subscribed and Sworn to Before Me MO. DAY YEAR Signature of Person Administering Oath S E A L SIGN IN PRESENCE OF NOTARY or driver license examiner Exam Center examiner Instructor.

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Keywords relevant to Dl 180c Printable

  • certify
  • notarized
  • Applicant
  • notary
  • accompanying
  • TAT
  • Learner
  • Supervised
  • spouse
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