Scribd Logo
Upload

Welcome to Scribd!

  • 401 views

    Certification of Address

    Uploaded by

    Madison Snyder
    This document is a certification of address form from the Florida Department of Highway Safety and Motor Vehicles. The form requires a person to certify their name, date of birth, residential address, and signature. For homeless or incarcerated individuals, additional documentation like a shelter letter or address verification from the Department of Corrections is needed along with the completed form. Acceptable proof of residential address is also required.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    Certification of Address

    Uploaded by

    Madison Snyder
    401 views1 page
    This document is a certification of address form from the Florida Department of Highway Safety and Motor Vehicles. The form requires a person to certify their name, date of birth, residential address, and signature. For homeless or incarcerated individuals, additional documentation like a shelter letter or address verification from the Department of Corrections is needed along with the completed form. Acceptable proof of residential address is also required.

    Original Description:

    For anyone looking to get their driver's license soon.

    Copyright

    © Attribution Non-Commercial (BY-NC)

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document is a certification of address form from the Florida Department of Highway Safety and Motor Vehicles. The form requires a person to certify their name, date of birth, residential address, and signature. For homeless or incarcerated individuals, additional documentation like a shelter letter or address verification from the Department of Corrections is needed along with the completed form. Acceptable proof of residential address is also required.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    401 views1 page

    Certification of Address

    Uploaded by

    Madison Snyder
    This document is a certification of address form from the Florida Department of Highway Safety and Motor Vehicles. The form requires a person to certify their name, date of birth, residential address, and signature. For homeless or incarcerated individuals, additional documentation like a shelter letter or address verification from the Department of Corrections is needed along with the completed form. Acceptable proof of residential address is also required.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES DIVISION OF MOTORIST SERVICES 2900 Apalachee Parkway Neil Kirkman Building

    - Tallahassee, FL 32399

    CERTIFICATION OF ADDRESS
    Date I do hereby certify that:

    Name

    (First)

    (Middle)

    (Last)

    Date of Birth

    Resides at:

    Street, Apartment

    City

    State

    Zip Code

    SPECIAL CONDITIONS: Self Certification Homeless* Released from Incarceration** Other

    Signature of Addressee/Customer INSTRUCTIONS:

    Print Name of Addressee/Customer

    Date

    A Certification of Address form completed and signed by the customer is accepted as proof of residential address, providing it is accompanied by: o One proof of residential address in the customers name or; o One proof of residential address in the name of the person with whom the customer resides. *** * Homeless customers may present a letter listing the customers name from a shelter, public assistance agency representative along with the completed Certification of Address form. ** Customers released from incarceration may present an Address Verification Letter from the Department of Corrections (with an Inmate Identification Card and Certificate of Discharge) along with the completed Certification of Address form. *** A list of documents that can be used as proof of residential address can be found at www.GatherGoGet.com. HSMV 71120 (Rev 04/13)

    You might also like