Kwy, Mail Stop 97 Tallahassee, FL 32399 Original Duplicate Lost-in-transit Section 1: REGISTRANT INFORMATION Registrant s Name as It Appears on Driver License Registrant s Phone Number (First, Full Middle/Maiden, & Last Name) (Voluntary) FL DL/ID or FEID/Suffix Number Registrant s Mailing Address I Registrant s Residential Street Address Registrant s Email (Voluntary) Sex Date of Birth City State Zip Code City State Zip Code Section 2: APPLICANT WITH ME.
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How to fill out the Sunscreening Medical Exemption Certificate online
This guide provides detailed instructions on how to accurately complete the Sunscreening Medical Exemption Certificate online. The process aims to ensure that users can easily navigate all necessary sections of the form to obtain their medical exemption.
Follow the steps to complete your Sunscreening Medical Exemption Certificate easily.
- Press the ‘Get Form’ button to retrieve the Sunscreening Medical Exemption Certificate and open it for editing.
- In Section 1, enter the registrant’s name as it appears on their driver license, including the first name, middle/maiden name, and last name.
- Fill in the registrant’s phone number and optional email address for communication purposes.
- Provide the Florida Driver License or Identification number and the associated suffix number, if applicable.
- Enter the registrant’s mailing address, including street address, city, state, and zip code.
- Complete the registrant’s residential street address details, ensuring accuracy as it is important for verification.
- In Section 2, include the applicant's name who has the medical condition, filling out everything as per the requirement.
- Indicate the medical condition the applicant has by checking the appropriate box that corresponds to their condition, including lupus, dermatomyositis, or other specified conditions.
- The applicant must sign and date the form to certify that the information provided is accurate and truthful.
- In Section 3, for any vehicles to be equipped with sunscreening material, provide the title number and vehicle identification number (VIN), along with the year and make of the vehicle.
- In Section 4, it is imperative that a certifying authority, such as a physician or licensed medical professional, completes the physician's statement by providing their name, license number, and business address.
- Finally, make sure the physician signs, dates, and provides their telephone number to validate their certification.
- Once all sections are thoroughly completed and reviewed, users can save their changes, download the form, print it for submission, or share it as required. To submit, follow the instructions for mailing provided at the top.
Complete and submit your Sunscreening Medical Exemption Certificate online today!
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