Florida Department of Highway Safety and Motor Vehicles · Florida state form
BAR1003A Affidavit of Refusal to Submit to Blood Test
This affidavit records an officer’s account of a driver refusing a requested blood test after a breath or urine test was impossible or impractical.
- What this form is
- BAR1003A is an affidavit for a law enforcement or correctional officer to complete when a driver refuses a requested blood test after a breath or urine test was impossible or impractical. It records the driver and officer details, the test request and warning, and the refusal. The document must be notarized or attested to before it is submitted with the driver’s license, appropriate UTC copy, and probable cause affidavit.
- Who needs it
- A law enforcement or correctional officer completes this affidavit to document a driver’s refusal to submit to a requested blood test.
- Why it needs a notary
- The affidavit must be notarized or attested to. Online notarization can be done with a commissioned online notary.
- How to submit it
- Mail or hand deliver it to the designated Bureau of Administrative Reviews office, Department of Highway Safety and Motor Vehicles, with the driver’s license, appropriate copy of the UTC, and probable cause affidavit.
Questions
What is BAR1003A used for?
A law enforcement or correctional officer uses BAR1003A to document a driver’s refusal to submit to a requested blood test when a breath or urine test was impossible or impractical.
Does BAR1003A need to be notarized?
Yes. The form states that the affidavit must be notarized or attested to. It can be notarized online with a commissioned online notary.
How do I submit the completed affidavit?
Mail or hand deliver the affidavit to the designated Bureau of Administrative Reviews office, Department of Highway Safety and Motor Vehicles, with the driver’s license, appropriate UTC copy, and probable cause affidavit.