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Get FL HSMV 71142 2011-2024

Date of birth First Middle Last be granted a Florida driver license and assume the obligations imposed by Section 322.09, Florida Statutes, unless and until I notify the Department to withdraw this consent. Signature of Parent or Legal Guardian Print Name STATE OF FLORIDA COUNTY OF Sworn to (or affirmed) and subscribed before me this by day of , 20 , who is personally known to me or produced Identification as proof of identification. (Identification type and number) Notary Public or .

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