Form HSMV 71120, (SPANISH) Certification of Address, is the Spanish-language residential address certification issued by the Florida Department of Highway Safety and Motor Vehicles (DHSMV) and published on the Alachua County Tax Collector's website. It is used with an application for a Florida Class E identification card or driver license when the applicant's proof of address comes from another person, who signs as the certifier. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the original is published at the agency's link.
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What is HSMV 71120?
Form HSMV 71120, printed in Spanish as Certificación de Dirección Residencial, is the Florida Department of Highway Safety and Motor Vehicles (DHSMV) sworn statement in which another person certifies that an applicant for a Class E identification card or driver license lives at their address.
The form exists because sections 322.051 and 322.08 of the Florida Statutes require applicants to give documents proving their residential address, and two documents from the approved list are required. When the applicant cannot provide two approved documents in their own name in Florida, this declaration is used together with the documents provided by the person whose name is on the proof of residential address.
The form has three parts:
- A. Información del Solicitante (applicant information), signed by the applicant.
- B. Información del Certificador (certifier information), where the person who provides the proof marks the documents and signs.
- C. Certificación del Notario Público o del Personal de Emisión, where a notary public or issuing personnel confirms the certifier's signature.
It is marked "Solo para Tarjetas de Identificación o Licencias de Conducir Clase E" (only for Class E identification cards or driver licenses). The form number and revision printed at the bottom are HSMV 71120 (Rev.10/01/2024).
Who needs to file HSMV 71120?
Applicants for a Florida Class E identification card or driver license who cannot provide two approved residential address documents in their own name in Florida use this form. The person whose name appears on the proof of address, and with whom the applicant lives, completes Part B as the certifier.
The form involves three people:
- The applicant gives their full name and residential address and signs Part A, certifying that the information is true and correct.
- The certifier states that the applicant lives at the certifier's residence, marks the documents provided as proof, and signs Part B.
- A notary public or issuing personnel completes Part C. The certifier's signature must be notarized, or witnessed by issuing personnel when the applicant is using the certifier's residential address documents.
Do not use this form for other kinds of licenses or cards: the form states it is only for Class E identification cards or driver licenses. The form says nothing about representatives signing for the applicant or the certifier.
When to file HSMV 71120
Use Form HSMV 71120 when you apply for a Florida Class E identification card or driver license and cannot provide two approved residential address documents in your own name; it is handed in with that application, so it has no separate due date of its own. The certifier's signature must be notarized or witnessed by issuing personnel, so plan for the certifier to sign in front of that person rather than in advance. Several of the supporting documents the certifier may provide must be dated within the last 30 days, so check their dates before you go to the office.
Documents you need
- One property information document in the certifier's name showing the residential address: Título de Propiedad (deed), Contrato de Hipoteca (mortgage agreement), Último Estado de Cuenta de la Hipoteca (most recent mortgage statement) or Contrato de Alquiler/Arrendamiento (rental/lease agreement).
- One supporting document in the certifier's name showing the residential address, chosen from the list printed in Part B; the items below are the options.
- Tarjeta de Registro de Votante de la Florida (Florida voter registration card), or Documentación de vehículos o embarcaciones de la Florida (Florida vehicle or vessel documentation).
- Tarjeta de Servicio Selectivo (Selective Service card) dated within the last 30 days.
- Utility bills from the last 30 days, such as water, gas, electricity, phone/cell or cable.
- Financial account statement from the last 30 days, such as a bank account, credit card or investment account.
- Professional license issued by a U.S. government agency.
- Employer documentation dated within the last 30 days, such as a pay stub or Form W-2.
- Home and/or auto insurance policy or bill dated within the last 30 days.
- Documents issued by Federal, State, County or City government agencies, dated within the last 30 days.
- FDLE registration form completed by the local sheriff's department or the Department of Corrections, dated within the last 30 days.
How to fill out HSMV 71120
Enter the applicant's name and address
In Part A, write the applicant's full name (Nombre Completo del Solicitante), then the residential address (Dirección Residencial), city, state and ZIP code (Código Postal) of the home where the applicant lives.
Sign the applicant certification
The applicant signs and dates the statement under Part A, certifying that the information is true and correct. The statement notes that willfully making a false statement in a driver license or identification card application is a crime under Florida law.
Enter the certifier's full name
In Part B, write the full name of the certifier (Nombre Completo del Certificador), the person who provides and certifies the proof of residential address. The applicant must live at this person's residence at the address given in Part A.
Check the property information document
Under the first Part B list, check one document in the certifier's name showing the residential address: deed, mortgage agreement, latest mortgage statement or rental/lease agreement.
Check the supporting document
Under the second Part B list, check one supporting document in the certifier's name, such as a voter registration card, utility bill, insurance policy or bill, or government-issued document. Where the form states a date limit, the document must be dated within the last 30 days.
Have the certifier sign and date
The certifier signs and dates in Part B, confirming the applicant lives at the address and that the documents provided are true. Do this in front of the notary public or issuing personnel.
Complete the notary or issuing personnel block
In Part C, the notary or issuing personnel enters the certifier's name, the day, month and year of the appearance, then signs and adds their full name, the state and county, and the seal. Issuing personnel also enter the date in the Exp. line.
Review and download the completed PDF
Check that every section is complete and the names match the documents. 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
The form is delivered in person: take it to your local tax collector's office or to a driver license service center. The form lists the DHSMV locations page at https://www.flhsmv.gov/locations-es/.
- Local tax collector's office: bring the completed form, with the certifier's documents, when you apply for the identification card or license. The Alachua County Tax Collector publishes this PDF on its website.
- Driver license service center: the form accepts delivery here as well.
- Signature requirement: the certifier's signature must be notarized, or witnessed by issuing personnel when the applicant is using that person's residential address documents. Part C is completed by the notary or issuing personnel.
The form prints no mailing address, online portal or fee. FillingPDF lets you fill out and download the PDF; submission follows the channels above.
Common mistakes to avoid
- Using the form when the applicant can provide two approved residential address documents in their own name in Florida; the form is for applicants who cannot.
- Having the applicant, not the person whose name is on the documents, act as certifier in Part B.
- Providing a supporting document older than the 30 days the form requires, such as an old utility bill or bank statement.
- Offering a property information document that is not in the certifier's name, or checking none of the four property options in Part B.
- Leaving the certifier's signature unnotarized or not witnessed by issuing personnel when the applicant is using the certifier's address documents.
- Signing Part C's notary section in advance: the certifier must appear before the notary or issuing personnel and sign in their presence.
- Omitting the applicant's or the certifier's signature or date; Parts A and B each have their own signature and date lines.
- Using the form for something other than a Class E identification card or driver license.
Frequently asked questions
What is Form HSMV 71120, Certification of Address?
Form HSMV 71120 is the Florida DHSMV residential address certification, printed here in Spanish. Another person certifies that a Class E ID or license applicant lives at their address and provides the approved documents that prove it, when the applicant lacks two approved documents in their own name.
Is this an Alachua County property tax form?
No. It is a Florida DHSMV form for proving the residential address of a Class E identification card or driver license applicant. The Alachua County Tax Collector publishes the PDF, and the form says it can be handed in at a local tax collector's office or a driver license service center.
Who needs to fill out Form HSMV 71120?
An applicant for a Class E ID or license who cannot provide two approved residential address documents in their own name in Florida. The person whose name is on the proof of address signs as certifier, and the applicant signs Part A.
What documents does the certifier need to provide?
One property information document in the certifier's name (deed, mortgage agreement, latest mortgage statement or lease) and one supporting document in the certifier's name, such as a utility bill, insurance bill or government document. Many supporting documents must be dated within the last 30 days.
Does Form HSMV 71120 have to be notarized?
The certifier's signature must be notarized, or witnessed by issuing personnel when the applicant is using the certifier's residential address documents. Part C is completed by the notary public or issuing personnel, and the certifier signs in their presence.
Where do I turn in the Certification of Address?
Take it to your local tax collector's office or to a driver license service center. The form lists the DHSMV locations page at https://www.flhsmv.gov/locations-es/. The form prints no mailing address or online submission option.
Can I fill out Form HSMV 71120 online on FillingPDF?
Yes. You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service and does not submit the form to the DHSMV or a tax collector; you hand it in through the channels the form gives.
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