DMV Driving Log Level2 NewBrand - NCDOT
Form
?DL-?©\4A
?
09/2011
?
DRIVING
?LOG
?TO
?ADVANCE
?TO
?N.C.
?LEVEL
?2
?LIMITED
?PROVISIONAL
?DRIVER
?LICENSE
?
REQUIREMENTS:
?
¡¤?
?
?
? Complete
?a
?minimum
?of
?60
?hours
?of
?driving.
?
¡¤?
?
?
? No
?more
?than
?10
?hours
?per
?week
?may
?count
?toward
?the
?60
?hours.
?
¡¤?
?
?
? At
?least
?10
?of
?the
?60
?hours
?must
?be
?at
?night.
?
¡¤?
?
?
? The
?log
?must
?be
?signed
?by
?a
?supervising
?driver
?and
?turned
?in
?to
?DMV
?upon
?application
?for
?the
?Level
?2
?driver
?license.
?
¡¤?
?
?
? A
?supervising
?driver
?must
?be
?a
?parent,
?grandparent,
?or
?guardian
?of
?the
?permit
?holder
?or
?a
?responsible
?person
?
?
approved
?by
?the
?parent
?or
?guardian,
?and
?must
?be
?a
?licensed
?driver
?who
?has
?been
?licensed
?for
?at
?least
?five
?years.
?
Customer
?Name:
?
?
?Customer¡¯s
?DL
?Number:
?
(Please
?Print
?Name)
?
I
?
,
?do
?certify
?that
?the
?information
?on
?this
?form
?is
?true
?and
?accurate
?and
?is
?
(Print
?Supervising
?Driver¡¯s
?Name)
?
in
?accordance
?with
?N.C.
?G.S.
?20-?©\11(d),
?
(Supervising
?Driver¡¯s
?Signature)
?
/
?
(Date)
?
/
?
Notice:
?If
?the
?Division
?has
?cause
?to
?believe
?that
?a
?driving
?log
?has
?been
?falsified,
?the
?limited
?learner¡¯s
?permit
?holder
?shall
?be
?
required
?to
?complete
?a
?new
?driving
?log
?with
?the
?same
?requirements
?and
?shall
?not
?be
?eligible
?to
?obtain
?a
?limited
?provisional
?license
?
for
?six
?months.
?
AMOUNT
?OF
?
SUPERVISING
?
TIME
?OF
?
TIME
?OF
?
DATE
?
DRIVING
?TIME
?
SUPERVISING
?DRIVER¡¯S
?PRINTED
?NAME
?
DRIVER¡¯S
?D L
?
?
DAY
?
NIGHT
?
(E.G.
?#
?HOURS)
?
(Number
?and
?State)
?
1
?of
?2
?
? Form
?DL-?©\4A
?
?
?
09/2011
?
?
TIME
?OF
?
DAY
?
DATE
?
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?
TIME
?OF
?
?
NIGHT
?
?
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?
AMOUNT
?OF
?
DRIVING
?TIME
?
(E.G.
?#
?HOURS)
?
?
?
?
?
?
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?
?
?
?
?
?
SUPERVISING
?
DRIVER¡¯S
?D L
?
?
(Number
?and
?State)
?
SUPERVISING
?DRIVER¡¯S
?PRINTED
?NAME
?
?
?
?
?
?
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?
?
Total Day Hours Driven:
?
_
Total Night Hours Driven:
2
?of
?2
?
_
Grand Total:______________
................
................
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