Transcription of APPLICATION FOR ADMINISTRATIVE HEARING
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APPLICATION FOR ADMINISTRATIVE HEARING
Florida Department of Highway Safety & Motor Vehicles Date received by Bureau of ADMINISTRATIVE Reviews APPLICATION FOR HARDSHIP/ ADMINISTRATIVE HEARING . Full Name Date of Birth _____. First Middle or Maiden Last Month/Day/Year Mailing Address _____. Street City State Zip Code Driver License Number _____ State _____. Applicant's Telephone Number: Residence ( ) Work ( ) _____. REASON SUSPENDED OR REVOKED _____. WHY DO YOU NEED TO DRIVE? _____. I acknowledge that to knowingly make a false statement or conceal a material fact is fraud and may result in the denial of a hardship license. _____. Signature of Applicant Date After completing this form, you may appear or call one of the Bureau of ADMINISTRATIVE Reviews offices listed below for a HEARING .
• At the hearing, you will be required to testify under oath and answer questions, including questions about your driving record and any violations contained therein, and why you should be granted a restricted license. BAR will then issue a written decision as to whether your request for a restricted license is granted or denied.
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