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Get FL HSMV 72034 2019-2024

Clearwater Daytona Beach Ft. Myers Ft. Pierce Gainesville Lantana Lauderdale Lakes Melbourne Miami Orlando Panama City Pensacola Tallahassee Tampa Winter Springs HSMV 72034 09/2015 Address 4585 140th Avenue North Suite 1002 995 Orange Avenue 4048 Evans Avenue Suite 305 3220 South Federal Highway Suite 8 2815 N.W. 13th Street Suite 302 7439 Wilson Boulevard 1299 West Lantana Road 3718-3 W. Oakland Park Blvd 2325 S. Babcock Street 7795 W. Flagler Street Suite 82C 4101 Clarcona-Ocoee Road Suite 152 237-A W. 15th Street Lincoln Center 100 Stumpfield Road 2900 Apalachee Parkway Room B-141 2814 East Hillsborough Avenue 154 Tuskawilla Road Suite 1368 Office Number 727 507-4405 386 254-3912 239 278-7421 772 468-4050 352 955-2030 904 777-2132 561 540-1190 954 677-5800 321 984-4910 305 265-3001 407 445-5581 850 872 7745 850 494-5728 850 617-2449 813 276-5795 407 327-6678 Fax Number 386 238-4744 772 460-3662 352 334-1597 954 714-3550 850 617-5077. Florida Department of Highway Safety Motor Vehicle Bureau of Administrative Reviews REQUEST FOR ELIGIBILITY REVIEW Driver s Full Name Telephone Number First Middle or Maiden Last Address Street City State Zip Code Driver License Number State I hereby request a review of my record for the purpose of determining my eligibility for immediate reinstatement of my driving privilege on a restricted basis as provided in section 322. 2615 1 b 3 Florida Statutes. I understand the restriction is for Business Purposes Only as defined in section 322. 271 Florida Statutes and I must pay a 25. 00 filing fee pursuant to section 322. 21 9 a. I understand that the restricted license will be for the duration of the suspension period imposed under section 322. 2615 Florida Statutes unless subsequently revoked by the court as follows Driving with an Unlawful Breath-Alcohol or Blood-Alcohol Level 6 months suspension Refusal to Submit to a Breath Blood or Urine Test 1 year suspension Reinstatement of the driving privilege on a restricted basis as set forth herein is conditioned on statutory eligibility requirements including but not limited to enrollment in DUI School* WAIVER OF FORMAL AND/OR INFORMAL REVIEW I also understand that acceptance of the reinstated driving privilege as provided in section 322. 271 7 c Florida Statutes is deemed a waiver of my right to a formal or informal review under section 322. 2615 Florida Statutes. Signature of Driver Witness Signature Witness Printed Name Office Hours - Monday through Friday 8 00 a*m* to 5 00 p*m* Jacksonville Orlando - Office Hours Monday through Friday 7 00 a*m* to 6 00 p*m. Florida Department of Highway Safety Motor Vehicle Bureau of Administrative Reviews REQUEST FOR ELIGIBILITY REVIEW Driver s Full Name Telephone Number First Middle or Maiden Last Address Street City State Zip Code Driver License Number State I hereby request a review of my record for the purpose of determining my eligibility for immediate reinstatement of my driving privilege on a restricted basis as provided in section 322. 2615 1 b 3 Florida Statutes. I understand the restriction is for Business Purposes Only as defined in section 322.

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