Print Reset Queensland Learner E-Logbook Transport Operations (Road Use Management) Act 1995 Learner licence number Family name Given name/s Residential address Postcode Postal address (if the same as your residential address, write as above) Postcode Daytime contact phone number Mobile phone number Email address Before lodging your Queensland Learner E-Logbook check: Each of the driving sessions (recorded in the logsheets) has been signed by the appropriate supervising driver. At least 100 hours (6000 minutes) of supervised driving experience has been recorded. At least 10 hours (600 minutes) of night driving as part of the 100 hours driving experience has been recorded. No more than 1800 minutes at triple time with an accredited driver trainer has been recorded. All manually completed logsheets are attached (if applicable). All pages of your e-logbook, including any attachments are securely bound before lodging. Remember: Lodge your logbook at an Australia Post outlet at least 12 business days prior to your Q-SAFE practical driving test. It will be sent via registered mail to the Department of Transport and Main Roads for checking. Privacy Statement The Department of Transport and Main Roads provides this form under the Transport Operations (Road Use Management) Act to determine if the learner driver has completed the 100 hours supervised driving experience requirement before being eligible to take the practical driving test for the granting of a Queensland provisional licence. The information collected in this form is accessible by authorised departmental persons and some of this information may be disclosed to the Queensland Police Service and interstate driver licensing authorities. The Department of Transport and Main Roads will not disclose your personal details to any other third parties without your consent unless authorised or required by law. Page 1 of 2 TRB Forms Area F4485 CFD V01 Sep 2015 Queensland Learner E-Logbook continued... page 2 of 3 Driving Experience Declaration Transport Operations (Road Use Management) Act 1995 Important information This form may be used if you have completed 100 hours supervised driving experience (including 10 hours night driving). Lodging your learner logbook and declaration does not guarantee that you will be automatically eligible to take your practical driving test to apply for a P1 provisional licence. You will be notified as soon as your logbook has been assessed. Section 1 - Learner drivers details Queensland learner licence number Given name/s Family name Date of birth Residential address Postcode Postal address (if same as your residential address, please write as above) Postcode Daytime contact phone number Mobile phone number Email address 1. The Department of Transport and Main Roads will assess your logbook and notify you of the result. Please indicate how you prefer to be notified (tick one box only) Mail Phone Email SMS 2. Do you hold, or have you ever held, a learner licence issued by another Australian state, territory or country? No Fill in your details below Yes Licence number Expiry date State/Territory/Country of issue Licence class/es 3. Please indicate how your 100 hours (including 10 hours night driving) supervised driving experience was gained (tick one box only) Driving experience with a supervisor (other than an accredited driver trainer) recorded in a Queensland Learner E-Logbook A combination of driving experience with a supervisor and an accredited driver trainer recorded in a Queensland Learner ELogbook A combination of prior driving experience (maximum 50 hours while the holder of a foreign learner licence) recorded on the Prior Driving Experience Application (form F4450) and driving experience on Australian roads recorded in a Queensland Learner E-Logbook. 4. A total of at least 100 hours (including 10 hours night driving) of supervised on-road driving is required prior to lodging this Queensland Learner E-Logbook and declaration. Please list your total of on-road driving experience in minutes (for example, 100 hours = 6000 minutes) minutes driving experience with an accredited driver trainer. Record as triple time (total minutes x 3) to a maximum 1800 minutes (30 hours) minutes daytime driving minutes night driving. Must be at least 600 minutes (10 hours) minutes prior driving experience (if applicable) minutes Total must be at least 6000 minutes (100 hours) 5. Learner drivers declaration I declare that I was the holder of a valid class C Queensland or equivalent non-Queensland learner licence when learning to drive. I understand that the Department of Transport and Main Roads will check the correctness and accuracy of the information I have provided. I declare that I have completed the number of supervised driving experience hours as detailed in this form. I give permission for the Department of Transport and Main Roads to access my driver licence record to confirm the information provided by me. I give permission for the Department of Transport and Main Roads to contact me for any further information considered necessary for the purpose of verifying information I have provided. I declare that the information I have provided in this form is complete, true and correct in every detail. Learner drivers signature Date Page 2 of 2 TRB Forms Area F4485 CFD V01 Sep 2015
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