Free Employment Certificate Template - Free Download
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Free Employment Certificate Template
Free Employment Certificate Template
www.dmv.ny.gov
I certify that ___________________________________________________ _______________________ is employed by me
at ________________________________________________ __________________________________________________.
CERTIFICATE OF EMPLOYMENT
If I am asked to do so by a police officer or magistrate, I will verify that these days and hours are correct.
I can be reached at __________________________________________________________________ ____________________________
Signature and
Title of Employer รง ____________________________________________________________________ ______________________
Mon. Tues. Wed. Thurs. Fri. Sat. Sun.
FROM
TO
HOURS OF EMPLOYMENT ARE:
MV-58A (12/15)
MV-58A (12/15)
(Address)
(Name of Licensee)
(Name of Business) (Address of Business)
(License ID #)
(Telephone Number)
(Date)
(SEPARATE THE TOP AND BOTTOM PARTS HERE.)
"
"
INSTRUCTIONS
The employer of a person holding a Class DJ or MJ license or Limited Class DJ or MJ license must complete this
certificate to allow the employee to drive to and from work unaccompanied by another licensed driver during specific
hours. The licensee must work at least once a week for at least four consecutive weeks.
The license holder must carry this certificate at all times when driving to and from work
. After separating the top of this form
from the bottom, the licensee should fold the top part and keep it with his/her driver license
.
RESTRICTIONS
This certificate is not valid for driving during the hours of employment (for example, to make deliveries or engage in
sales) except for farm employment as indicated below.
This certificate is not valid for driving in New York City at any time.
This certificate allows the Class DJ and Class MJ licensee to drive to and from
his/her place of employment after 9 p.m.
except in New York City, Nassau and Suffolk counties. In Nassau and Suffolk counties, this certificate allows the
Class DJ and Class MJ licensee to drive to and from
his/her place of employment only between 5 a.m. and 9 p.m; it also
allows the licensee to drive while engaged in farm employment
at any time.
This certificate allows the Limited Class DJ and Limited Class MJ licensee to drive to and from
his/her place of
employment anytime, except in New York City, Nassau, Suffolk, Westchester, Rockland and Putnam counties. With a
Limited Class DJ or Limited Class MJ license, this certificate cannot be used at any time to drive in New York City,
Nassau, Suffolk, Westchester, Rockland and Putnam counties.
Free Employment Certificate Template Previous Page
source: dmv.ny.gov
Free Employment Certificate Template
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