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6 views3 pages

PDF Document

Uploaded by

accojuvera
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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A component of The Parent’s Supervised Driving Program provided

free to DMV’s and Licensing Agencies throughout the country.

Supervised Driving Log

Driver Name: Total Driving Time:

Parent Name: Total Night Driving Time:

The verifying signature must be from one of the signers of the Affidavit of Liability and
Guardianship, from DR 2460, or from the Driver Education Instructor. Please check all
totals prior to signing. By signing below, I certify that the above total hours of driving
experience is true and accurate.

Signed Date
Parent/Guardian or Driver Education Instructor

With Support From


Driver Name: acco cuevas juvera
Parent Name: amanda juvera

Total Driving Time: 52 Hrs, 54 Mins, 21 Secs


Total Night Driving Time: 19 Hrs, 53 Mins, 41 Secs

Date Time Duration Weather Road Type Day/Night Notes

03/18/2023 3:53 PM MDT 29 Mins Normal Local Road Day


03/20/2023 10:02 PM MDT 45 Mins Normal Local Road Night
03/20/2023 10:59 PM MDT 0 Mins Normal Local Road Night
03/20/2023 11:00 PM MDT 0 Mins Normal Local Road Night
03/20/2023 11:00 PM MDT 3 Mins Normal Local Road Night
04/12/2023 8:52 PM MDT 10 Mins Normal Local Road Night
04/12/2023 9:14 PM MDT 0 Mins Normal Local Road Night
04/12/2023 9:15 PM MDT 17 Mins Normal Local Road Night
04/17/2023 9:10 PM MDT 1 Min Normal Local Road Night
06/08/2023 8:26 PM MDT 21 Mins Normal Local Road Day
09/06/2023 7:30 PM MDT 9 Mins Normal Local Road Night
09/11/2023 9:26 PM MDT 40 Mins Normal Local Road Night
12/16/2023 9:17 PM MST 4 Mins Normal Local Road Night
02/08/2024 9:23 PM MST 21 Mins Normal Local Road Night
03/10/2024 3:54 PM MDT 0 Mins Normal Local Road Day
Date Time Duration Weather Road Type Day/Night Notes

03/10/2024 3:54 PM MDT 30 Hrs, 2 Mins Normal Local Road Day


04/02/2024 3:07 PM MDT 12 Mins Normal Local Road Day
04/03/2024 5:30 PM MDT 34 Mins Normal Local Road Day
04/03/2024 6:54 PM MDT 28 Mins Normal Local Road Day
04/04/2024 7:54 AM MDT 19 Mins Normal Local Road Day
04/11/2024 3:05 PM MDT 14 Mins Normal Local Road Day
04/30/2024 6:19 PM MDT 3 Mins Normal Local Road Day
04/30/2024 6:32 PM MDT 15 Mins Normal Local Road Day
05/08/2024 10:19 PM MDT 1 Hr, 25 Mins Normal Local Road Night
05/12/2024 9:23 PM MDT 15 Hrs, 53 Mins Normal Local Road Night

Total Driving Time: Driver Signature:

52 Hrs, 54 Mins, 21 Secs _____________________________

Total Night Driving Time: Parent Signature:


19 Hrs, 53 Mins, 41 Secs _____________________________
Date:

_____________________________

Note to Maryland Residents:


Only page one of this document, the
"Certification for Rookie Drivers", needs to be
provided to the MDOT MVA.

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