Clients who have received a cancellation letter from the Department of Highway Safety and Motor Vehicles which states that the client needs form 77096 (Reprieve Letter) Please select either A or B below.
For clients who completed treatment, but the DUI school never received treatment completion documents from the treatment provider, please select A below.
For clients who did not comply with the treatment referral or who did not complete the required treatment please select B below.
In order to obtain the HSMV Form 77096, it will be necessary for you to contact your treatment provider and have them email that you completed treatment to Florida Safety Council.
to make an appointment to pick up the reprieve letter and pay the $10.00 processing fee.
You may look up the number of your treatment agency by referring to the Treatment Agency list that is contained on this link.
The treatment agency will need to email the completion document to:
Once the treatment agency emails the completion, Florida Safety Council will complete you for the treatment obligations and notify DHSMV of your completion. However, the local hearing office will still need to have the Form 77096 (Reprieve Letter) to locally remove the cancellation.
You will then be issued the HSMV Form 77096 (Reprieve Letter) once the treatment agency sends the completion document.
This letter will then need to be delivered to the Department of Motor Vehicles Hearing Office. This will remove a cancellation for failure to complete the required substance abuse treatment.
In order to obtain the HSMV Form 77096, it will be necessary for you to contact your treatment provider and have them email that you completed treatment to Florida Safety Council. You may look up the number of your treatment agency by referring to the Treatment Agency list that is contained on this link.
You will then need to fill out two forms. The Treatment Referral and/or Documentation form and the Request for Reprieve Letter form.
These forms can be downloaded from this link.
It will then be necessary for you to fill out both forms and email them back to the Florida Safety Council at:
Please be sure to fill the treatment referral form out for a treatment provider from the treatment agency list.
Contact the treatment provider to make an appointment to start treatment by making a first appointment
Have the treatment provider email Florida Safety Council that you have initiated the treatment process.
There is a $15.00 fee for selecting a treatment provider and a $10.00 fee for processing the Reprieve Letter.
Call Florida Safety Council at:
to make an appointment to pick up the reprieve letter and pay the fees noted above.
If you don't complete the treatment, your license will be cancelled. The Reprieve Letter is a One Time Only Reprieve.