Abstract of Lifetime Driving Record - New York DMV

1 Record Summary Line(SAMPLE)[SIGNATURE]DEPUTY COMMISSIONER OF MOTOR VEHICLESS tate o* New york DEPARTMENT OF MOTOR VEHICLES. Empire State Dlaza, Albany, New york 12228 STATUS: REVOKEDABSTRACT OF Lifetime Driving RECORDDOCUMENT#: UFC0019 TIME: 16:26:58ID NUMBER: 522367836 MOTORIST,MICHELLE 6 EMPIRE STATE PLZ ALBANY, NY 12228-0001(SAMPLE)OPERATOR: JFCPRINT DATE: 11/30/2018 OFFICE: ITSMAILING COUNTY: ALBANYNAME ON LICENSE/ID: MOTORIST MICHELLEDATE OF BIRTH: 01/25/1983 HEIGHT: 5-06 RESTRICTIONS: IGNITION INTERLOCK DEVICE, CORRECTIVE LENSES Record Summary Line .LICENSE CLASS:ENDORSEMENTS: NONEGENDER: FEMALE EYE COLOR: BLUEEXPIRATION: 01/25/201819A STATUS: NOT APPLICABLE HAZMAT STATUS: NOT APPLICABLE** to**.

2 , -i** t *.* * ** * * * SUSPENSION / REVOCATION SUMMARY* * **+* ** ** SUSPENSION/REVOCATION SUMMARY - TOTAL OPEN: 3 (OPEN SCOFFLAWS 1 ON 1 DATES)**4+*+**#*^activity** * ** + * 't +** t * * * **QASS CHANGE /PRIVILEGE CHANGE**CLASS CHANGE: NEW: *D* OLD: *DJ* 01/25/2001 CLASS CHANGE: NEW: *DJ* OLD: PERMIT 06/17/1999**,M**r** ** *(.* ** #*OO tjMENTS ISSUED** **CLASS: D CLASS; OJISSUED: 01/25/2001 ISSUED: 06/17/1999 TYPE: LICENSE TYPE: PERMIT4 * 4 * 4 ** * + ** 4 * * 4 * ** j * 4 4 ** * + ** 4 *4 ** 4 + +** + + 4 * - 4 * * i * iM* i HID NUMBERS: 446408707, 522367836 NAME: MOTORIST,MICHAEL DATE OF BIRTH: 01/01/1534 RESULT:522367836 POST DATE: 04/02/1999 GENDER; MALE** ** 4*4 * * ** *| [VTPAIRED Driving PROGRAM* ** *The Undersigned certifies, on behalf of the New york State Department of Motor Vehicles (DMV>.))]

3 That this document is a true and complete copy of an electronic Record that is on file at DMV, in Albany, New york . This Record was made in the ordinary course of DMV s regular business, it is the business of the DMV io create and maintain the records of drivers in the State of New york . Entries in this document are made contemporaneously with the time the recorded transactions or events took place, or within a reasonable time thereafter. The person who reports the information to Record such transactions or events performs this function pursuant to a business duty to do so 1 of 3 SIGNATURE] (12/18)PAGE 1 OF 7 State of New york DEPARTMENT OF MOTOR VEHICLES.

4 Empire State Dfaza, Albany, New york 12228 Abstract OF Lifetime Driving RECORDDOCUMENT#: UFC0019 TIME: 16:26:58 OPERATOR: JFCPRINT DATE: 11/30/2018 OFFICE: ITSID NUMBER: 522367836 START DATE: 10/07/2016 PROVIDER: 0065 PROVIDER: 0065 END DATE: 11/23/2016 STATUS: COMPLETEDSUSPENSIONS / REVOCATIONSNON-SCOFFLAWS** ** **'**SUSPENSION EFFECTIVE: 03/14/2011 REASON: INSURANCE NOT IN EFFECT ORDER#:C1103010000 CLASS AFFECTED: ALLCLEAR ONCASE#: C101271 PERIOD: INDEFINITE TERMINATION FEE: $50 DUE REASON:REVOCATION EFFECTIVE: 01/28/2011 REASON: REFUSED TO SUBMIT TO A CHEMICAL TEST ORDER#: H1102180000 CASE #: ]CLASS AFFECTED: ALL PERIOD:CIVIL PENALTY: $500 DUE TERMINGCLEAR ON: REASONINCIDENT DATE: 12/16/2010 REVOCATION EFFECTIVE: 01/30/2001 REASON: COURT REVOCATION ORDER#: D0101190000 CLASS AFFECTED: ALLCLEAR ON: 10/05/2002 CASE#: D0102719 TICKEPERIOD: 1 YEAR EVEN WITHOUT DDP TERMINATION FEE: NO FEE DUE REASON; REAPPLICATION APPROVED* SCOFFLAWS** * **.

5 ** ** " ** '** * **SUSPENSION EFFECTIVE: 07/22/2011 REASON: FAILURE TO PAY FINE (SCOFFLAW)ORDER #: Z060 QDHLOCATION: CHEMUNG COUNTY, TOWN OF VETERAN CLEAR ON: REASONTICKET #: 100600 DHJ1 The Undersigned certifies, on behalf of the New york State Department of Motor Vehicles |DMV), that this document is a true and complete copy of an electronic Record that is on file at DMV. in Albany, New york . This Record was made in the ordinary course of DMVs regular business. It is the business of the DMV to create and maintain the records of drivers in the State of New york . Entries in this document are made contemporaneously with the time the recorded transactions or events took place, or within a reasonable time thereafter.

6 The person who reports the information to Record such transactions or events performs this function pursuant to a business duty to do so accurately.[SIGNATURE]DEPUTY COMMISSIONER OF MOTOR (12/18)PAGE 2 OF 7 State o* New york DEPARTMENT OF MOTOR VEHICLES. Empire State Dlaza, Albany, New york 12228>: *D*STATUS: REVOKEDABSTRACT OF Lifetime Driving RECORDDOCUMENT#: UFC0019 TIME: 16:26:58ID NUMBER: 522367836 MOTORIST,MICHELLE 6 EMPIRE STATE PLZ ALBANY, NY 12228-0001(SAMPLE)OPERATOR: JFCPRINT DATE: 11/30/2018 OFFICE: ITSMAILING COUNTY: ALBANYNAME ON LICENSE/ID: MOTORIST MICHELLEDATE OF BIRTH: 01/25/1983 HEIGHT: 5-06 RESTRICTIONS: IGNITION INTERLOCK DEVICE, CORRECTIVE LENSES Record Summary Line.

7 LICENSE CLASS:ENDORSEMENTS: NONEGENDER: FEMALE EYE COLOR: BLUEEXPIRATION: 01/25/201819A STATUS: NOT APPLICABLE HAZMAT STATUS: NOT APPLICABLE** to**., -i** t *.* * ** * * * SUSPENSION / REVOCATION SUMMARY* * **+* ** ** SUSPENSION/REVOCATION SUMMARY - TOTAL OPEN: 3 (OPEN SCOFFLAWS 1 ON 1 DATES)**4+*+**#*^activity** * ** + * 't +** t * * * **QASS CHANGE /PRIVILEGE CHANGE**CLASS CHANGE: NEW: *D* OLD: *DJ* 01/25/2001 CLASS CHANGE: NEW: *DJ* OLD: PERMIT 06/17/1999**,M**r** ** *(.* ** #*OO tjMENTS ISSUED** **CLASS: D CLASS; OJISSUED: 01/25/2001 ISSUED: 06/17/1999 TYPE: LICENSE TYPE: PERMIT4 * 4 * 4 ** * + ** 4 * * 4 * ** j * 4 4 ** * + ** 4 *4 ** 4 + +** + + 4 * - 4 * * i * iM* i HID NUMBERS: 446408707, 522367836 NAME: MOTORIST,MICHAEL DATE OF BIRTH: 01/01/1534 RESULT:522367836 POST DATE: 04/02/1999 GENDER; MALE** ** 4*4 * * ** *| [VTPAIRED Driving PROGRAM* ** *The Undersigned certifies, on behalf of the New york State Department of Motor Vehicles (DMV>.))]

8 That this document is a true and complete copy of an electronic Record that is on file at DMV, in Albany, New york . This Record was made in the ordinary course of DMV s regular business, it is the business of the DMV io create and maintain the records of drivers in the State of New york . Entries in this document are made contemporaneously with the time the recorded transactions or events took place, or within a reasonable time thereafter. The person who reports the information to Record such transactions or events performs this function pursuant to a business duty to do so 1 of 3 SIGNATURE]DEPUTY COMMISSIONER OF MOTOR (12/18)PAGE 1 OF 7 State o* New york DEPARTMENT OF MOTOR VEHICLES.

9 Empire State Dlaza, Albany, New york 12228>: *D*STATUS: REVOKEDABSTRACT OF Lifetime Driving RECORDDOCUMENT#: UFC0019 TIME: 16:26:58ID NUMBER: 522367836 MOTORIST,MICHELLE 6 EMPIRE STATE PLZ ALBANY, NY 12228-0001(SAMPLE)OPERATOR: JFCPRINT DATE: 11/30/2018 OFFICE: ITSMAILING COUNTY: ALBANYNAME ON LICENSE/ID: MOTORIST MICHELLEDATE OF BIRTH: 01/25/1983 HEIGHT: 5-06 RESTRICTIONS: IGNITION INTERLOCK DEVICE, CORRECTIVE LENSES Record Summary Line .LICENSE CLASS:ENDORSEMENTS: NONEGENDER: FEMALE EYE COLOR: BLUEEXPIRATION: 01/25/201819A STATUS: NOT APPLICABLE HAZMAT STATUS: NOT APPLICABLE** to**.

10 , -i** t *.* * ** * * * SUSPENSION / REVOCATION SUMMARY* * **+* ** ** SUSPENSION/REVOCATION SUMMARY - TOTAL OPEN: 3 (OPEN SCOFFLAWS 1 ON 1 DATES)**4+*+**#*^activity** * ** + * 't +** t * * * **QASS CHANGE /PRIVILEGE CHANGE**CLASS CHANGE: NEW: *D* OLD: *DJ* 01/25/2001 CLASS CHANGE: NEW: *DJ* OLD: PERMIT 06/17/1999**.*t*,*M *tM^o .D0 CUMENTS ISSUED**CLASS: D CLASS; OJISSUED: 01/25/2001 ISSUED: 06/17/1999 TYPE: LICENSE TYPE: PERMIT** + ** ** ** +** >* *> + ** *+> +MERG $** * *'** ** + ** ' - +*ID NUMBERS: 446408707, 522367836 NAME: MOTORIST,MICHAEL DATE OF BIRTH: 01/01/1534 RESULT:522367836 POST DATE: 04/02/1999 GENDER; MALE** ** 4*4 * * ** *| [VTPAIRED Driving PROGRAM* ** *The Undersigned certifies, on behalf of the New york State Department of Motor Vehicles (DMV>.)]