OHIO DEPARTMENT OF PUBLIC SAFETY BUREAU OF MOTOR VEHICLES EMPLOYER APPROVAL FOR PROBATIONARY DRIVER LICENSE HOLDERS DRIVING WITHIN RESTRICTED HOURS Pursuant to Ohio Revised Code (R.C.) 4507.071(B)(1), the following restrictions apply to drivers under the age of 18: When the probationary license has been held for less than twelve months, the license holder is not permitted to drive between midnight and six a.m. unless the license holder is accompanied by their parent or guardian. When the probationary license has been held for twelve months or longer, the license holder is not permitted to drive between one a.m. and five a.m. unless the license holder is accompanied by their parent or guardian. R.C. 4507.071(B)(2) allows for the probationary license holder to drive to or from work during the restricted hours described above if the license holder has immediate possession of written documentation from their employer. This form is available to use as written documentation permitting the probationary driver license holder to drive between the restricted hours. Complete both sections below. SECTION A - PROBATIONARY DRIVER LICENSE HOLDER INFORMATION NAME DRIVER LICENSE # SECTION B - COMPLETED BY EMPLOYER CURRENT EMPLOYER EMPLOYER ADDRESS BEGINNING DATE OF EMPLOYMENT NAME OF MANAGER CITY STATE TELEPHONE # ZIP ENDING DATE OF EMPLOYMENT (IF KNOWN) EMPLOYEE WORK SCHEDULE SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY EMPLOYER SIGNATURE START TIME A.M. A.M. A.M. A.M. A.M. A.M. A.M. P.M. P.M. P.M. P.M. P.M. P.M. P.M. END TIME A.M. A.M. A.M. A.M. A.M. A.M. A.M. P.M. P.M. P.M. P.M. P.M. P.M. P.M. TITLE DATE X BMV 2825 8/15 [760-1491] American LegalNet, Inc. www.FormsWorkFlow.com