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• Record of Daytime Driving Hours Daytime

Time Location Conditions Qualified Supervising Driver


Learner’s
Date Signature
Start Finish Duration From To Road Weather Traffic Name Licence No. Signature
am/pm am/pm

Learner’s Sub Total


(minutes) Road Type Weather Traffic Density Foreign or Interstate Licence
Permit Holder Sealed S Dry D Light L Country/State.......................... Expiry Date / / Yrs Held...................
Name Unsealed U Wet W Medium M
Quiet Street Q Heavy H Warning:
Busy Road B
Permit No. Multi-laned
Heavy penalties apply for false entries, please see pages 6 and 25. If the
Road ML Qualified Supervising Driver’s Licence cannot be validated, the entry will be
rejected and any licence issued will be void. Incomplete entries are invalid.

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