Hsmv 72034 2026

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The document is a request form from the Florida Department of Highway Safety & Motor Vehicle for individuals seeking an eligibility review to reinstate their driving privileges on a restricted basis. It outlines the necessary information required from the driver, the conditions for reinstatement, including payment of a filing fee and enrollment in DUI School, as well as the implications of waiving formal review rights.

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Click ‘Get Form’ to open the hsmv 72034 in the editor.
Begin by entering your full name in the designated field, ensuring accuracy for identification purposes.
Provide your telephone number, including area code, to facilitate communication regarding your request.
Fill in your complete address, including street, city, state, and zip code. This information is crucial for processing your request.
Enter your driver license number and the state of issuance. This helps verify your driving record.
Read the eligibility statement carefully and sign where indicated. Ensure you understand the implications of requesting a restricted license.
Include a witness signature along with their printed name and date to validate your request.

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