Florida Certification of Address Form: Sections, Signature, Submission

Florida’s Certification of Address form, HSMV 71120, lets you prove where you live when you don’t have two address documents in your own name. You fill out Section A with your information, the person you live with fills out Section B and supplies two of their own address documents (one from a household-information list, one from a supporting-documents list), and their signature is either notarized ahead of time or witnessed by staff at the office. You bring the whole packet in person to a tax collector’s office or driver license service center.¹

When You Need It

Florida requires two residential address documents for a Class E driver license or ID card application.² If you can’t produce two documents that show your own name at your current address, HSMV 71120 lets someone you live with vouch for you using their documents instead.¹ This comes up most often after a recent move, for young adults without utility accounts, or when a spouse or family member holds all the household bills.

The certifier has to be someone who owns or leases the home where you live. The form itself doesn’t restrict the relationship: parent, spouse, roommate, or anyone else on the deed or lease can sign, as long as they can back it up with the right documents.¹

What Your Certifier Must Bring

This is where applications stall. The certifier can’t just show up with any two address documents. The form splits the requirement into two categories, and they need one from each. Every document must show the certifier’s name and the same residential address.¹

One household information document:

Deed or mortgage
Property tax record
Recent monthly mortgage statement
Rental or lease agreement

One supporting document:

Florida voter registration card
Professional license from a U.S. government agency
Selective Service card
Employer documentation dated within the last 60 days (pay stub, W-2)
Florida vehicle or vessel documentation
Utility bill dated within the last 60 days (water, gas, electric, phone, cable)
Homeowner’s or auto insurance policy or bill dated within the last 60 days
Financial statement dated within the last 60 days (bank, credit card, or investment account)
Government-issued document from a federal, state, county, or city agency dated within the last 60 days
FDLE registration form completed by the local sheriff’s department or Department of Corrections within the last 30 days

Watch the freshness dates. A utility bill from three months ago doesn’t qualify, and neither does a 45-day-old FDLE registration.

Filling Out Section A

Section A is yours. Enter your full legal name exactly as it appears on your identity documents, then your current residential street address with any apartment or unit number, city, state, and zip code. That address should match the certifier’s, since the whole point of the form is to confirm you live there. Sign and date at the bottom. Print clearly in black ink if you’re handwriting it.¹

Filling Out Section B

Section B is completed by the certifier. They enter their full legal name and residential address, then check off which documents they’re providing from each of the two categories. They sign and date the section, affirming that you live at their residence and that the documents they’re supplying are accurate.¹

How the Certifier’s Signature Gets Validated

The certifier’s signature has to be either notarized or witnessed by issuance personnel at the office.¹ Two paths work:

The certifier comes with you and signs Section B in front of the examiner. No notary needed.
The certifier can’t come with you. They sign Section B in front of a notary public first, and you bring the notarized form in yourself.³

Bringing your certifier along is simpler and skips the notary fee. If their schedule won’t allow it, a notarized form is accepted without issue, as long as the notary has stamped and signed before you arrive.

Where to Submit the Form

Take the completed form and the certifier’s two address documents to a Florida tax collector’s office or driver license service center. This is an in-person transaction; the form doesn’t reference a mail-in option.¹

HSMV 71120 only satisfies the residential address requirement. You still need to bring everything else your application calls for: proof of identity, proof of Social Security number, and any additional items on the FLHSMV’s “What to Bring” list for your situation.²

You can download the current form (revision 12/24) at flhsmv.gov or pick one up at any tax collector’s office or service center.¹ If you’re using a printed copy someone handed you, check the revision date at the bottom and grab a fresh one if it’s older.

Penalties for False Information

Both signatures on the form carry weight. Making a false statement or concealing a material fact on a Florida driver license or ID card application is a third-degree felony, punishable by up to five years in prison.⁴ That exposure applies to the certifier as well as the applicant. Vouching for someone who doesn’t actually live at the address isn’t a favor worth the risk.

1
Florida Department of Highway Safety and Motor Vehicles. Certification of Address (HSMV 71120)
2
Online Sunshine. Florida Statutes 322.08 – Application for License; Requirements for License and Identification Card Forms
3
Florida Department of Highway Safety and Motor Vehicles. U.S. Citizen
4
Online Sunshine. Florida Statutes 322.212 – Unauthorized Possession of, and Fraud Relating to, Driver Licenses and Identification Cards