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Get NC DMV DL-4A 2011

Form DL-4A 09/2011 DRIVING LOG TO ADVANCE TO N.C. DRIVING2LOG LEVEL LIMITED PROVISIONAL DRIVER LICENSE REQUIREMENTS Date Location of Practice Time of Weather Time Parent/ Skills Practiced Conditions Spent e.g. Guardian Complete e.g. highway residential hours of driving. Day a minimum of 60 initials 6-17-10 than 10 hours per week may count toward the 60 hours. 45hour No more Parking lot 4 00 pm Sunny mins LK Parking backing braking At least 10 of the 60 hours must be at night. The log must be signed by a supervising driver and turned in to DMV upon application for the Level 2 driver license. A supervising driver must be a parent grandparent or guardian of the permit holder or a responsible person approved by the parent or guardian and must be a licensed driver who has been licensed for at least five years. Customer Name Customer s DL Number Please Print Name I do certify that the information on this form is true and accurate and is Print Supervising Driver s Name in accordance with N*C. G*S* 20-11 d Supervising Driver s Signature Notice If the Division has cause to believe that a driving log has been falsified the limited learner s permit holder shall be required to complete a new driving log with the same requirements and shall not be eligible to obtain a limited provisional license for six months. AMOUNT OF TIME OF DATE DRIVING TIME SUPERVISING DRIVER S PRINTED NAME Driver s DL DAY NIGHT E*G* HOURS Number and State Total Hours 1 of 2 Total Day Hours Driven Total Night Hours Driven 2 of 2 Grand Total. Day a minimum of 60 initials 6-17-10 than 10 hours per week may count toward the 60 hours. 45hour No more Parking lot 4 00 pm Sunny mins LK Parking backing braking At least 10 of the 60 hours must be at night. The log must be signed by a supervising driver and turned in to DMV upon application for the Level 2 driver license. The log must be signed by a supervising driver and turned in to DMV upon application for the Level 2 driver license. A supervising driver must be a parent grandparent or guardian of the permit holder or a responsible person approved by the parent or guardian and must be a licensed driver who has been licensed for at least five years. A supervising driver must be a parent grandparent or guardian of the permit holder or a responsible person approved by the parent or guardian and must be a licensed driver who has been licensed for at least five years. Customer Name Customer s DL Number Please Print Name I do certify that the information on this form is true and accurate and is Print Supervising Driver s Name in accordance with N*C. Customer Name Customer s DL Number Please Print Name I do certify that the information on this form is true and accurate and is Print Supervising Driver s Name in accordance with N*C. G*S* 20-11 d Supervising Driver s Signature Notice If the Division has cause to believe that a driving log has been falsified the limited learner s permit holder shall be required to complete a new driving log with the same requirements and shall not be eligible to obtain a limited provisional license for six months. .

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