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Get TX DPS DL-90A 1999

Take this form to the DPS to apply for the Instruction Permit. DRIVER EDUCATION AFFIDAVIT I valid driver license number Instructor s Name hereby certify that I am the instructor of Student s Legal Name a person who is legally required to successfully complete a driver training course to obtain a Class C driver s license. X Other DPS-approved classroom instruction Course 102 or 103 Course 102 Title of DPS Approved Curriculum used Driver Education Certificate form DE-964 completed at driver license office I acknowledge that falsely certifying the Texas Driver Education Certificate form DE-964 is punishable as a third degree Felony under Article 4413 29c V. T. C. S. which includes imprisonment for a period not to exceed five years. Signature Date Sworn to and subscribed before me this day of 20. Notary Public in and for the State of Texas / Authorized Officer PLEASE NOTE One affidavit is required for each instructor who actually teaches a student in each phase of the course. The student s date of birth is. MM-DD-YYYY I further certify that I have not been convicted of Criminally Negligent Homicide or Driving While Intoxicated and that I am not disabled because of mental illness. Public Safety approved course of instruction mark only one area of instruction. 32 hours of classroom block instruction* Approved textbook used 32 hours clasroom instruction concurrent with laboratory. X Other DPS-approved classroom instruction Course 102 or 103 Course 102 Title of DPS Approved Curriculum used Driver Education Certificate form DE-964 completed at driver license office I acknowledge that falsely certifying the Texas Driver Education Certificate form DE-964 is punishable as a third degree Felony under Article 4413 29c V. T. C. S* which includes imprisonment for a period not to exceed five years. Signature Date Sworn to and subscribed before me this day of 20. Notary Public in and for the State of Texas / Authorized Officer PLEASE NOTE One affidavit is required for each instructor who actually teaches a student in each phase of the course. If there is more than one instructor this form may be photocopied for use by the second instructor. If both instructors are not able to accompany the student when applying for an Instruction Permit the affidavit for the absent instructor will need to be notarized prior to appearing in the Driver License Office. The document s must be presented when the student applies for an Instruction Permit. Definition of a qualified instructor can be found on page VIII of the instruction packet. The student s date of birth is. MM-DD-YYYY I further certify that I have not been convicted of Criminally Negligent Homicide or Driving While Intoxicated and that I am not disabled because of mental illness. Public Safety approved course of instruction mark only one area of instruction. 32 hours of classroom block instruction* Approved textbook used 32 hours clasroom instruction concurrent with laboratory. Public Safety approved course of instruction mark only one area of instruction. 32 hours of classroom block instruction* Approved textbook used 32 hours clasroom instruction concurrent with laboratory. X Other DPS-approved classroom instruction Course 102 or 103 Course 102 Title of DPS Approved Curriculum used Driver Education Certificate form DE-964 completed at driver license office I acknowledge that falsely certifying the Texas Driver Education Certificate form DE-964 is punishable as a third degree Felony under Article 4413 29c V. .

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