Form 433M alaska parental consent for a minor motorcycle application

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Form 433m (Rev. 08/2018) alaska.gov/dmv 433 M STATE OF ALASKA DIVISION OF MOTOR VEHICLES PARENT/GUARDIAN CONSENT FOR A MINOR FOR A MOTOR DRIVEN CYCLE Pursuant to Alaska Statute 28.15. 051(d) , an application for a person under the age of 18 must be signed by natural parent s or legal guardians . The per son who authorizes issuance of the license or permit is liable for damages caused by the minor when driving a motor driven cycle. You may file a written request to cancel the license or permit. The above applies until the minor reaches 18 years of age. P lease complete in ink: I, and , hereby give our consent for Parent/Guardian 1 Parent/Guardian 2 whose date of birth is to obtain: Applicant’s Name SELECT ONLY ONE AGE Alaska Motor -Driven Cycle Permit (Class M2) ....................................................................................................... (14 - 15) Alaska Motorcycle/Moto r-Driven Cycle Instruction Permit (IM) ............................................................................ (14 - 17) Alaska Provisional Motorcycle License (Class M1)* ............................................................................................. (16 - 17) Alaska Motorcycle License (Class M1)** ................................ ................................ ................................ ................ (16 - 17) * Must have held a valid permit for the class of license applying for (IP for D or IM for M1) for at least 6 months with no violations. ** Must have held a valid Provisional license (D or M1) for 6 months with no violations or repeat minor consuming offense. *** Must only operate on public roads in communities that allow operation through a local ordinance that conforms to AS 28.01.010(a). We agree to assume full financial responsibility for this individual until his/her 18 th birthday. We understand that we may file a request to cancel the license/permit at any time. To obtain a Provisional License, we certify that the applicant has had at least 10 hours of driving experience in inclement weather (snow, ice, rain, darkness, etc.) for a total of 40 hours driving experience. Parents Driver’s License #: Issuing State: Your Relationship to Applicant : Your Mailing Address: Email Phone Signature: Sworn and subscribed before me this ____________ day of _________, 20 Notary Public or DMV Representative ( LOGIN ID & Office Number) AMVC________ / Office # ________ My Commission Expires : Parents Driver’s License #: Issuing State: Your Relationship to Applicant: Your Mailing Address: Email Phone Signature: Sworn and subscribed before me this ____________ day of _________, 20 Notary Public or DMV Representative ( LOG IN ID & Office Number) AMVC________ / Office # ________ My Commission Expires: