Form HSMV 71120, Certification of Address, is the affidavit the Florida Department of Highway Safety and Motor Vehicles (HSMV) publishes for Class E driver license and identification card applicants; this copy is hosted by the Alachua County Tax Collector. It is not a property tax form, so if you came looking for Alachua County property tax, note that a property tax document appears here only as one of the proofs a certifier may provide. You use it when you cannot supply two approved Florida residential address documents in your own name and the person whose name is on those documents certifies your address. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the form is submitted to a local tax collector office or driver license service center.
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What is HSMV 71120?
Form HSMV 71120, Certification of Address, is the Florida Department of Highway Safety and Motor Vehicles (HSMV) affidavit that lets an applicant use another person's residential address documents to prove a Florida residential address when applying for a Class E driver license or identification card.
The form is marked "For Class E Driver License or Identification Cards Only." It rests on sections 322.051 and 322.08, Florida Statutes, which require applicants to provide proof of residential address documents. Two residential address documents from the approved documents list are required. When the applicant cannot provide two approved Florida residential address documents in their own name, this affidavit is used together with the documents provided by the person whose name is on them.
The form has three parts:
- A. Applicant Information: the person applying, their residential address and their signed certification.
- B. Certifier Information: the person providing and certifying the proof of address, with one household information document and one supporting document in the certifier's name.
- C. Notary Public or Issuance Personnel Acknowledgment: confirms that the certifier signed in the presence of a notary or issuance personnel.
The revision printed on the form is HSMV 71120 (Rev. 12/24). This copy is published by the Alachua County Tax Collector, and the form itself tells applicants to submit it to a local tax collector office or driver license service center. It is not a property tax form: Property Tax appears only as one of the household information documents a certifier may provide.
Who needs to file HSMV 71120?
Applicants for a Florida Class E driver license or identification card who cannot provide two approved Florida residential address documents in their own name use this form. The affidavit is then used along with the documents provided by the person whose name is on the proof of Florida residential address documents.
That person is the certifier. The form describes the certifier as the person providing and certifying residential proof of address, and states that the applicant resides at the certifier's residence at the address listed. The certifier must provide one household information document in their name showing that they own or lease the property, which gives them the authority to let the applicant use the address, plus one supporting document in their name.
The certifier's signature must be notarized or witnessed by issuance personnel when the customer is using that person's residential address documents.
Do not use this form for anything other than a Class E driver license or identification card; the form is marked for those only.
When to file HSMV 71120
Complete the form when you apply for a Florida Class E driver license or identification card and cannot provide two approved Florida residential address documents in your own name. The form prints no separate deadline; it goes in with the application and the certifier's proof of address.
Check the dates on the certifier's documents before you go. Utility bills, employer documentation, insurance policies or bills, financial statements and documents issued by federal, state, county or city agencies must be dated within the last 60 days. An FDLE Registration form completed by the local sheriff's department or Department of Corrections must be dated within the last 30 days.
The certifier signs in the presence of a notary public or issuance personnel, so plan the signing for a time when the certifier can be there.
Documents you need
- One household information document in the certifier's name showing the residential address: Deed/Mortgage, Property Tax, Recent Monthly Mortgage Statement, or Rental or Lease Agreement. It shows the certifier owns or leases the property.
- One supporting document in the certifier's name with the residential address, such as a Florida Voter Registration Card, a professional license issued by a U.S. government agency, a Selective Service card, or Florida Vehicle or Vessel Documentation.
- Alternatively, as the supporting document: utility bills dated within the last 60 days (water, gas, electricity, telephone/cell, cable, etc.).
- Alternatively, as the supporting document: employer documentation dated within the last 60 days, such as a paycheck stub or W-2 form.
- Alternatively, as the supporting document: an insurance policy or bill for homeowner's and/or automobile coverage dated within the last 60 days.
- Alternatively, as the supporting document: a financial statement dated within the last 60 days, such as a bank, credit card or investment account statement.
- Alternatively, as the supporting document: a document issued by a federal, state, county or city government agency dated within the last 60 days.
- Alternatively, as the supporting document: an FDLE Registration form completed by the local sheriff's department or Department of Corrections dated within the last 30 days.
How to fill out HSMV 71120
Confirm the form applies to you
Use it only for a Florida Class E driver license or identification card, and only when you cannot provide two approved Florida residential address documents in your own name.
Enter the applicant's information
In Section A, enter the Applicant Full Name, Residential Street Address, City, State and Zip Code of the person applying.
Sign and date the applicant certification
Below the Section A statement, the applicant signs and enters the Date, confirming the information is true and correct.
Enter the certifier's full name
In Section B, enter the Certifier Full Name: the person whose name is on the residential proof documents and at whose residence the applicant lives.
Check the household information document
Check one box for the document in the certifier's name showing ownership or lease of the property: Deed/Mortgage, Property Tax, Recent Monthly Mortgage Statement, or Rental or Lease Agreement.
Check the supporting document
Check one box for the supporting document in the certifier's name, such as a utility bill or insurance bill dated within the last 60 days, or any other listed option with its date limit.
Have the certifier sign and date
The certifier signs and dates Section B in the presence of a notary public or issuance personnel, since the signature must be notarized or witnessed.
Leave Section C to the notary
The notary public or issuance personnel completes Section C: the certifier's name, the day, month and year of appearance, the seal, printed name, signature, and the State and County.
Review, download and bring the documents
Check that both signatures, dates and the checked boxes are complete, then download or print the completed PDF from FillingPDF and take it with the certifier's documents to the office described under How to submit.
How to submit HSMV 71120
Submit the completed form to your local tax collector office or to a driver license service center. The form lists the HSMV office locator at https://www.flhsmv.gov/offices/.
- Local tax collector office: bring the signed form and the certifier's proof of address documents with your application.
- Driver license service center: the same package is accepted there, as the form directs.
- Certifier's signature: it must be notarized, or witnessed by issuance personnel at the office, when you are using the certifier's residential address documents. Section C is completed by the notary public or issuance personnel.
The form prints no mailing address, fax number or online portal. FillingPDF lets you fill out and download the PDF; submission follows the channels above.
Common mistakes to avoid
- Using the form for anything other than a Class E driver license or identification card; the form is marked for those only.
- Providing only one proof document for the certifier. The form requires one household information document and one supporting document, both in the certifier's name.
- Offering a document in the applicant's name or another person's name instead of the certifier's name with the residential address.
- Using a utility bill, employer document, insurance bill, financial statement or government document dated more than 60 days back, or an FDLE Registration form older than 30 days.
- Having the certifier sign without a notary public or issuance personnel; the signature must be notarized or witnessed when the applicant uses that person's address documents.
- Listing an address where the applicant does not live at the certifier's residence. The form warns it is a crime to knowingly make a false statement on a license or ID application.
- Leaving the applicant or certifier signature or date blank in Section A or Section B.
- Submitting the form alone without the documents provided by the person whose name is on the proof of residential address.
Frequently asked questions
What is Form HSMV 71120 used for?
Form HSMV 71120, Certification of Address, is a Florida HSMV affidavit for Class E driver license or identification card applicants. It lets the applicant use residential address documents in another person's name when they cannot provide two approved Florida residential address documents in their own name.
Who can be the certifier on a Certification of Address?
The certifier is the person whose name is on the proof of residential address documents and at whose residence the applicant lives. The certifier must supply one household information document, such as a deed or lease, showing they own or lease the property, plus one supporting document in their name.
Does the Certification of Address have to be notarized?
The certifier's signature must be notarized or witnessed by issuance personnel when the applicant is using that person's residential address documents. Section C records this: the certifier signs in the presence of a notary public or issuance personnel, who completes the seal and signature lines.
What proof of address does the certifier need to provide?
One household information document (Deed/Mortgage, Property Tax, Recent Monthly Mortgage Statement, or Rental or Lease Agreement) and one supporting document, such as a Florida Voter Registration Card, utility bill or insurance bill. Both must show the residential address in the certifier's name.
How recent must the supporting documents be?
Utility bills, employer documentation, insurance policies or bills, financial statements and government agency documents must be dated within the last 60 days. An FDLE Registration form completed by the local sheriff's department or Department of Corrections must be dated within the last 30 days.
Where do I submit Form HSMV 71120?
Submit it to your local tax collector office or driver license service center. The form points to the HSMV office locator at https://www.flhsmv.gov/offices/. It prints no mailing address or online portal.
Is Form HSMV 71120 a property tax form?
No. It is an HSMV affidavit of residential address for Class E driver license or identification card applicants. Property Tax appears on it only as one of the four household information documents a certifier may provide to show they own or lease the property.
Can I fill out the Certification of Address online?
You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service and does not file the form; you deliver it to a tax collector office or driver license service center, and the certifier's signature must still be notarized or witnessed.
What happens if false information is given on this form?
Both the applicant and the certifier sign statements saying that, under Florida law, it is a crime to knowingly make any false statement relating to the application for a driver license or identification card. Enter only true information and documents.
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