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SCHEDULE 11E+W+S FORMS OF CERTIFICATE AND STATEMENT OF PRACTICAL AND UNITARY TEST RESULT

PART 1E+W+S TEST PASS CERTIFICATE

Certificate of passing the [extended*] test of competence to driveE+W+S

Driver number....................

Date of test....................

Test Centre....................

I certify that [Name of candidate] has been examined and has PASSED the test of competence prescribed for the purposes of section 89 of the Road Traffic Act [and section 36 of the Road Traffic Offenders Act*] 1988 in respect of vehicles in category/categories....................

Whether vehicle fitted with automatic transmission....................Y/N.

Whether vehicle modified/other restrictions....................

Signature of examiner....................

Signature of candidate....................

*Words in italics to be omitted where inapplicable.