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Get FL HSMV 72870 2015-2021

A 45 reinstatement fee is required for a suspended license. Note This form may only be accepted within 30 calendar days of its completion. HSMV 72870 07/15. NOTIFICATION TO THE DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES STUDENT COMPLIANCE WITH ATTENDANCE REQUIREMENTS FOR REINSTATEMENT OF DRIVING PRIVILEGE/ELIGIBILITY FOR LICENSURE This is to provide verification to the Department of Highway Safety and Motor Vehicles that the following student who received Notice of Intent to Suspend/Withhold Eligibility for Licensure due to non-attendance is in compliance with attendance requirements in S* 322. 091 1. Student s Full Legal Name First Middle Last Mailing Address Driver License/Control Number Gender MaleFemale Date of Birth // Social Security Number District Name District Number School Name School/Institution Number Date // Authorized Signature of School Official Signature must be notarized or school seal affixed Title Typed or Printed Name of Person Signing Form Notary Public State of Florida at Large School Seal Original signatures required* For additional information contact Name You may mail fax or e-mail this completed form to DHSMV 2900 Apalachee Parkway MS 39 Tallahassee Florida 32399-0570. The fax number is 850 -617-5095 and the e-mail address is Truancy flhsmv*gov* If the license is suspended present this form to a driver license or a tax collector s office for reinstatement of your driving privilege. NOTIFICATION TO THE DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES STUDENT COMPLIANCE WITH ATTENDANCE REQUIREMENTS FOR REINSTATEMENT OF DRIVING PRIVILEGE/ELIGIBILITY FOR LICENSURE This is to provide verification to the Department of Highway Safety and Motor Vehicles that the following student who received Notice of Intent to Suspend/Withhold Eligibility for Licensure due to non-attendance is in compliance with attendance requirements in S* 322. 091 1. Student s Full Legal Name First Middle Last Mailing Address Driver License/Control Number Gender MaleFemale Date of Birth // Social Security Number District Name District Number School Name School/Institution Number Date // Authorized Signature of School Official Signature must be notarized or school seal affixed Title Typed or Printed Name of Person Signing Form Notary Public State of Florida at Large School Seal Original signatures required* For additional information contact Name You may mail fax or e-mail this completed form to DHSMV 2900 Apalachee Parkway MS 39 Tallahassee Florida 32399-0570. 091 1. Student s Full Legal Name First Middle Last Mailing Address Driver License/Control Number Gender MaleFemale Date of Birth // Social Security Number District Name District Number School Name School/Institution Number Date // Authorized Signature of School Official Signature must be notarized or school seal affixed Title Typed or Printed Name of Person Signing Form Notary Public State of Florida at Large School Seal Original signatures required* For additional information contact Name You may mail fax or e-mail this completed form to DHSMV 2900 Apalachee Parkway MS 39 Tallahassee Florida 32399-0570. The fax number is 850 -617-5095 and the e-mail address is Truancy flhsmv*gov* If the license is suspended present this form to a driver license or a tax collector s office for reinstatement of your driving privilege..

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