Drive Time Log Sheet Section 7 - Please print

Parent Name:_______________________ Student Name:
Customer ID:    

 

Date: _______________                       Driving Time: _______________                      Night Driving:_______________ 

      Comments: ________________________________________________________________________________

Verifier’s Initials: _______        

 

Date: _______________                       Driving Time: _______________                      Night Driving:_______________ 

      Comments: ________________________________________________________________________________

Verifier’s Initials: _______        

 

Date: _______________                       Driving Time: _______________                      Night Driving:_______________ 

      Comments: ________________________________________________________________________________

Verifier’s Initials: _______        

 

Date: _______________                       Driving Time: _______________                      Night Driving:_______________ 

      Comments: ________________________________________________________________________________

Verifier’s Initials: _______        

 

Date: _______________                       Driving Time: _______________                      Night Driving:_______________ 

      Comments: ________________________________________________________________________________

Verifier’s Initials: _______        

 

Date: _______________                       Driving Time: _______________                      Night Driving:_______________ 

      Comments: ________________________________________________________________________________

Verifier’s Initials: _______        

 

Date: _______________                       Driving Time: _______________                      Night Driving:_______________ 

      Comments: ________________________________________________________________________________

Verifier’s Initials: _______        

 

Date: _______________                       Driving Time: _______________                      Night Driving:_______________ 

      Comments: ________________________________________________________________________________

Verifier’s Initials: _______        

 

Date: _______________                       Driving Time: _______________                      Night Driving:_______________ 

      Comments: ________________________________________________________________________________

Verifier’s Initials: _______        

Total Time:                                                  Night Time:

The verifying signature must be from one of the signers of the Affidavit of Liability and Guardianship. Please check all totals prior to signing. By signing below, I certify that the above total hours of driving experience are true and accurate.


Signed: _______________________________________ Date: ______________

           (Parent/Guardian or Driver Education Instructor)