Fillable Pre-DPS Trip Guide (City of Oakland)

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Pre-DPS Trip Guide (City of Oakland)

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The Pre-DPS Trip Guide (City of Oakland) form is 16 pages long and contains:

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  • 3 check-boxes
  • 12 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Oakland

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Pre-DPS Trip Guide
For Getting Your Permit
Here's everything you get in your guide!
PAGE 2 | DPS Checklist
What to bring to the DPS. Follow this checklist to make your trip as
easy and stress-free as possible.
PAGE 3 - 7 | Examples
Step-by-step instructions on how to fill out your paperwork.
Classroom Instruction Log Record
Texas Residency Affidavit
Texas Driver Education Certificate
PTDE Instructor Designation Form
Blank Forms
We've included unmarked copies of logs for you and your parent
to use for classroom and behind-the-wheel instruction. In
addition, you can find other required blank forms here.
Note: Only the Classroom Instruction Log is required to get your
permit. Hang onto your Behind-the-Wheel logs for when you
start practicing in the car.
PAGE 8 - 13 |
1
Learner's Permit - DPS Checklist
F
o
llo
w this chec
klist
to m
ake your trip to the
DPS as e
asy and
stress
-free
as possible.
Forms from the PTDE Program Guide
PTDE Program Guide Receipt Page - it's just the
first page of your Program Guide from TDLR
Lost a form? Download a copy of your Program Guide here.
*Looking for the Classroom Instruction Driver Education
Affidavit? Great news: it's no longer required! Recycle it!
Forms From Aceable
Proof of Social Security
Bring your original Social Security card. Copies are
not accepted.
Application for Driver License or
Identification Card (DL-14A)
Get this at the DPS office when you are there.
$16 Learner License Application Fee
Payable by cash, credit, check, or money order.
Permit Certificate (DE-964) - Emailed to you!
Classroom Instruction Log
A blank copy can be found on page 8 of this guide or visit
aceable.com/
texasdrivinglogs to download and print.
Verification of Enrollment (VOE) Form
A blank copy can be found on page 10 of this
guide. Get this filled out and signed by a school
administrator. It expires after 30 days!
Is your school closed for vacation? Find tips at aceable.com/voe.
Official Parent Instructor
This is the person you registered online through
the Texas Department of Licensing and Regulation.
If your instructor is a designated individual instead of your
parent/grandparent/legal guardian, you must complete the
PTDE Instructor Designation Form (page 11) and bring it to the
DPS.
Note: If your parent has had a Texas driver license for less than 3
years, they need to bring a driver record showing 3 years of
driving history from the state or country in which they previously
held a license.
Proof of Student's Identity & Lawful Presence
Mandatory PTDE Program Guide from Texas
Dept of Licensing and Regulation (TDLR)
Learn more.
Did you finish Level 1 before ordering the program guide?
Follow these steps:
1. Make sure you have an eligible instructor before ordering.
2. Order the Program Guide ASAP from TDLR and download
it from the website or by using the link given in the receipt
TDLR emails you.
3. Print your forms out!
4. Email us at support@aceable.com with the date that you
ordered the program guide. We will update your
certificate date to be at least 3 days after your order date.
[Hint: No need to email us if you ordered the packet
before finishing Level 1!]
You can either provide:
Texas ID, US Passport, or US Citizenship Certificate
-OR-
Original Birth Certificate AND
Original Social Security Card AND
One of these items: Report Card, Photo ID Card*,
Immunization Records*, Medicare/Medicaid Card*
*Documents must be issued by an institution, entity, or
government agency from a US state or territory. For a complete
list of options, visit aceable.com/dl-57.
Proof of Texas Residency
Your parent/legal guardian will confirm your Texas
residency to DPS by bringing the following items:
Texas Residency Affidavit
A blank copy can be found on page 9 of this guide.
Two of the following items under their name:
Mortgage Statement, Utility Bills, Bank/Card
Statements, Deed, Report Card, W-2, Auto
Insurance
Note: Both
documents must show the same name and address,
be dated within 30-90 days, and come from two different
sources. Your parent instructor does not need to live with you;
they just need to have a Texas address. For a complete list of
options, visit aceable.com/dl-57.
If your instructor is not your parent/grandparent/legal guardian,
bring the person
you live with to the DPS to confirm your Texas
residency.
2
Filling Out Your PTDE Packet and Certificate
Examples on how to fill out your PTDE packet and certificate.
Questions? Visit help.aceable.com
Understanding our Example Pages
Helpful notes are written in RED.
Examples are written in BLUE.
DO NOT use these example forms at the DPS - this is just a guide. Lost or misplaced
your forms? Head over to TDLR’s website to download a new copy of your program
guide
packet.
3
CLASSROOM INSTRUCTION LOG
Student’s Name:
Instructors Name:
Date Classroom Instruction Began:
Instructor’s Driver License #:
Date Classroom Instruction Completed:
TDLR-Approved Course #: 116
Unit
Hours Required
Date Completed
Instructor Signature
Level 1: Ch 1, 2, & 3
2
Level 1: Ch 4 & 5
2
Level 1: Ch 6, 7, 8, & 9
2
Level 2
2
Level 3
2
Level 4
2
Level 5
2
Level 6
2
Level 7
2
Level 8: Ch 1 & 2
2
Level 8: Ch 3 & 4
2
Level 8: Ch 5 & 6
2
Level 9
2
Level 10
2
Level 11
2
Level 12
2
Total
32
This form is also referred to as the DL-91A.
Legal name of student getting permit
Date began Level 1
Leave blank
Parent/Legal Guardian Instructor's Legal
Name
^ This person's driver license #
Day 1
Day 2
Day 
HOW TO LOG YOUR
ONLINE HOURS :
ll dates that you list must be N
or FT the date that you
ordered the Program Guide
pacet from TDL.
For eample ce obot ordered
his PTD Program Guide from
TDL on 1/1/218. This means
the first date he can list on this
log must be 1/1/218  a later
date. ny date listed before
1/1/218 ill not be accepted by
DP.
Only fill out Level 1! Keep the
remaining levels blank. You'll
work on those after you get your
permit.
Leave blank until
after getting permit
As you complete each level, fill in the date and have your instructor sign off on it. [Note: 6-hour levels are
broken into three 2-hour sections.] You may be required to present this form at the DPS when you apply for
your learner license and provisional license.
REMEMBER: Per state requirement, you cannot log more than 2 hours per day. The classroom portion of
Parent Taught Drivers Ed cannot be completed in less than 16 days.
This is an EXAMPLE.
A blank copy can be found on page 8 of this document.
EXAMPLE ONLY
4
Robot Ace R 01 01 2000
08/29/16
P P
00000000
√
√
√
Signature of Parent /Guardian Instructor
<- This person's driver license #
This is not an official certificate - use this example to help you fill out your own certificate which was emailed to you.
EXAMPLE ONLY
5
Texas Residency
A
ffi
davit
Instructions for completion are on back of form
To be eligible for a Texas driver license or identification card, the applicant must be a resident of or domiciled in Texas.
If the applicant cannot provide two acceptable residency documents from the list found on the back of this form, this
affidavit may be used as evidence of residency in Texas.
*Texas domicile rules are in the Texas Administrative Code (37 TAC §§ 15.49 and 16.15).
The applicant for a Texas driver license or identification card must complete Section A.
A. Applicant Information
Name
Residence Address
City
State
ZIP Code
I certify that the information provided above is true and correct. I understand that according to Texas law, it is a crime
to knowingly make any false statement relating to the application for a driver license or identification card.
Applicant’s Signature
Date
A representative who provides services to the applicant at the address in Section A must complete Section B certifying
that the applicant resides or receives services at that address.
The individual who resides at the address in
Section A
must complete
Section B
certifying that the applicant resides at
that address and providetwo acceptable documentsestablishing proof of residency. If theindividual who completes
Section B
is not related to the applicant, they must accompany the applicant and submit this affidavit in person.
B. Individual or Representative Information
Name of Individual or Representative
If a representative, please provide the affiliate organization
Business or Residence Address
City
State
ZIP Code
The applicant and the individual or representative must sign Section B.
The individual or representative for the applicant must certify and sign the following section. I certify the information
submitted on behalf of the above applicant is true and correct. The applicant does live at my residence or receives
services at the location listed above. I understand that according to Texas law, it is a crime to knowingly make any false
statement relating to application for a driver license or identification card.
Certifier’s Signature
Date
Notarization (if required) may be provided in the space below
DL-5 (Rev. 2/13)
Student Information Goes Here
Parent or Legal Guardian Instructor's
Information Goes Here
IGNORE. You do NOT need a notary signature if you sign this section in front of the DPS clerk.
* DO NOT SIGN UNTIL IN FRONT OF THE DPS CLERK!*
* DO NOT SIGN UNTIL IN FRONT OF THE DPS CLERK!*
This is an EXAMPLE.
A blank copy can be found on page 9 of this document.
EXAMPLE ONLY
6
THIS FORM IS REQUIRED IF THE PARENT/ LEGAL GUARDIAN IS NOT THE INSTRUCTOR
Section 1001.112, Education Code, allows a parent, legal guardian or a judge of a court with jurisdiction over the person to
designate an individual to conduct a PTDE course in their place.
Requirements for the instructor you are designating:
❖ Be at least 25 years of age or older
❖ May not charge a fee for conducting the course
❖ Has at least seven (7) years driving experience
❖ Possess a valid driver license for the past three years that has not been suspended, revoked or forfeited
for an offense that involves the operation of a motor vehicle
❖ Has not been convicted (including a probated sentence) of criminally negligent homicide
❖ Has not been convicted (including a probated sentence) for driving while intoxicated in the past 7 years
❖ Not have six or more points assigned to their driver license
Instructors are responsible for checking their criminal and/or driver record to confirm eligibility prior to instructing an
approved PTDE course. If DPS determines the instructor does not meet eligibility the license issuance will be denied.
Any classroom or in-car instruction provided by an ineligible instructor will be voided.
I, , hereby designate ,
(Print Parent / Legal Guardian / Judge Name) (Print Instructor Designee Name)
driver license number , to conduct a TDLR approved PTDE course for my student
(Instructor Designee Driver License Number)
, date of birth .
(Print Student Full Name) (MM/DD/YYYY)
I certify that the above-named student, I am the:
Parent Legal Guardian Judge with jurisdiction over the student
(Parent / Legal Guardian / Judge Signature) (Date)
(Instructor Designee Signature) (Date)
PTDE Instructor Designation Form (12/2017)
TAKE THIS FORM WITH YOU TO THE DEPARTMENT OF PUBLIC SAFETY
This is an EXAMPLE. A blank copy can be found on page 11 of this document.
P
ARENT
T
AUGHT
D
RIVER
E
DUCATION
D
ESIGNATION
F
ORM
Your Parent/Legal Guardian/Judge's Name
Your Designated Individual's Name
Designated Individual's Driver
License Number
Write in the student's full name here
Student's Birthdate
Check off one of the options above. Who is authorizing the designated individual to be your PTDE instructor?
Your Parent/Legal Guardian/Judge signs here
The date they signed this
Your Designated Individual signs here
The date they signed this
About this form:
This form is ONLY required for students with an instructor who is
not a parent, step-parent, grandparent, step-grandparent, foster
parent, or legal guardian. This individual must meet the
requirements listed on this form. Print out the blank form on page
13, complete it, and bring it to the DPS for your permit.
EXAMPLE ONLY
7
CLASSROOM INSTRUCTION LOG
Student’s Name:
Instructors Name:
Date Classroom Instruction Began:
Instructor’s Driver License #:
Date Classroom Instruction Completed:
TDLR-Approved Course #: 116
Unit
Hours Required
Date Completed
Instructor Signature
Level 1: Ch 1, 2, & 3
2
Level 1: Ch 4 & 5
2
Level 1: Ch 6, 7, 8, & 9
2
Level 2
2
Level 3
2
Level 4
2
Level 5
2
Level 6
2
Level 7
2
Level 8: Ch 1 & 2
2
Level 8: Ch 3 & 4
2
Level 8: Ch 5 & 6
2
Level 9
2
Level 10
2
Level 11
2
Level 12
2
Total
32
This form is also referred to as the DL-91A.
As you complete each level, fill in the date and have your instructor sign off on it. [Note: 6-hour levels are
broken into three 2-hour sections.] You may be required to present this form at the DPS when you apply for
your learner license and provisional license.
REMEMBER: Per state requirement, you cannot log more than 2 hours per day. The classroom portion of
Parent Taught Drivers Ed cannot be completed in less than 16 days.
8
Texas Residency
A
ffi
davit
Instructions for completion are on back of form
To be eligible for a Texas driver license or identification card, the applicant must be a resident of or domiciled in Texas.
If the applicant cannot provide two acceptable residency documents from the list found on the back of this form, this
affidavit may be used as evidence of residency in Texas.
*Texas domicile rules are in the Texas Administrative Code (37 TAC §§ 15.49 and 16.15).
The applicant for a Texas driver license or identification card must complete Section A.
A. Applicant Information
Name
Residence Address
City
State
ZIP Code
I certify that the information provided above is true and correct. I understand that according to Texas law, it is a crime
to knowingly make any false statement relating to the application for a driver license or identification card.
Applicant’s Signature
Date
A representative who provides services to the applicant at the address in Section A must complete Section B certifying
that the applicant resides or receives services at that address.
The individual who resides at the address in
Section A
must complete
Section B
certifying that the applicant resides at
that address and provide two acceptable documents establishing proof of residency. If the individual who completes
Section B
is not related to the applicant, they must accompany the applicant and submit this affidavit in person.
B. Individual or Representative Information
Name of Individual or Representative
If a representative, please provide the affiliate organization
Business or Residence Address
City
State
ZIP Code
The applicant and the individual or representative must sign Section B.
The individual or representative for the applicant must certify and sign the following section. I certify the information
submitted on behalf of the above applicant is true and correct. The applicant does live at my residence or receives
services at the location listed above. I understand that according to Texas law, it is a crime to knowingly make any false
statement relating to application for a driver license or identification card.
Certifier’s Signature
Date
Notarization (if required) may be provided in the space below
DL-5 (Rev. 2/13)
9
School Name/Home School
Verification of Enrollment and Attendance
(VOE) Form
County-District-Campus No. (If
Applicable)
Planned Use of Data: To provide documentation of enrollment and attendance status to the Texas Department of Public Safety
(DPS) for a student applying for a learner’s license and/or a license to operate a motor vehicle. The student presents the completed
form to DPS. DO NOT provide this VOE to the Texas Education Agency (TEA).
Authority: Section 521.204 of the Texas Transportation Code requires students under age 18 who have not obtained a high school
diploma or its equivalent to be enrolled in a public, charter, home, or private school; GED Program; or Institution of Higher Education
and meet specific enrollment conditions to obtain or renew a license.
Contacts: DPS www.dps.texas.gov or TEA/Driver Training www.esc13.net/drivers.
Issuing VOE Forms: The issuance or denial of the VOE is strictly a local school, charter, GED program, or institution decision.
Neither DPS nor TEA can alter a VOE decision. It is recommended that schools, charters, GED programs, and institutions of
higher education clearly outline all requirements for issuance of a VOE and establish a formal, published policy to support
the requirements.
Texas Education Code, Section 25.092 states that a student may not be given credit for a class unless the student is in attendance
for at least 90% of the days the class is offered. The 90% attendance rule applies when determining VOE eligibility. Schools can
accept decisions of attendance committees when considering VOE eligibility. Summer school does not count as make-up time for
attendance purposes unless the attendance committee makes summer school attendance a part of a student’s plan to make up
days missed. For students in grades eight and below, absences may be aggregated on the basis of a scholastic year. For students
in grades 9-12, absences may be aggregated on the basis of a scholastic semester (traditional, condensed, accelerated, block,
etc.).
VOE Eligibility:
1) The school considers the student currently enrolled at the time the student applies for the VOE, and
2) the school awarded the student credit for each class the semester prior to application for the VOE.
If the student was not awarded credit for each class the semester prior to application for the VOE, the school should examine
attendance records for the semester prior to application for the VOE and determine whether the student was present 90% of the
time each class was offered. If so, the VOE may be issued. If the student did not receive credit and did not attend 90% of their
classes, the school attendance committee and/or administration may approve a plan establishing conditions for the student to meet
in order to receive a VOE.
A student must meet one of the following requirements to receive a VOE. The individual certifying attendance verifies on
behalf of the school, program, or institution the following as true and correct by marking the appropriate box and affixing a
legal signature to this form. Entities may personalize and/or develop their own VOE provided all pertinent information
contained on this form is incorporated.
Public, charter, home, or private schools: The public, charter, home, or private school should mark this box and issue the
form to any student who is currently enrolled AND either:
(1) met minimum attendance for class credit (90 Percent Rule) in each class they were enrolled in semester,
(2) received credit for all courses taken in the previous semester, OR
(3) has complied with the conditions established by the school to receive this VOE form.
GED programs: GED programs mark this box and issue the VOE to any student who:
(1) is currently enrolled,
(2) has been enrolled in the program for a minimum of 45 calendar days, and
(3) is meeting the attendance requirements prescribed by the GED program.
Institutions of higher education: Institutions mark this box and issue the form to students who have not obtained a diploma
or its equivalent but are enrolled and attending as prescribed by the institution. Note: Institutions can issue a letter signed by an
official of the institution stating that (1) the student is currently enrolled and (2) the student is meeting the institution’s
attendance requirements instead of issuance of this form.
Typed or Printed Name of Student
Date
Student Signature *
Typed or Printed Name and Title of
Administrator/Designee
Area Code &
Telephone
Issuance Date
/ /
Month Day Year
Administrator/Designee Signature
Parental/Guardian Permission: I grant my permission for the Texas Department of Public Safety (1) to access my child’s school
enrollment records and (2) for a school administrator or law enforcement officer to notify DPS in the event that my child has been
absent from school for a at least 20 consecutive instructional days.
Parent/Guardian Signature: ______________________________________________ Date: _____________________________
Expiration: Any VOE issued during the school year (traditional, year round, etc.) expires 30 days after issuance. Any VOE
issued the last 5 days of the school year will expire the first day of the following school year.
* A student is not required to sign in the presence of the person certifying attendance. The signature of the student can be placed on
the form before or as it is presented to DPS.
THE VOE IS A GOVERNMENT RECORD AS DEFINED UNDER TEXAS PENAL CODE, 37.01(2). ANY MISREPRESENTATION
BY THE APPLICANT OR PERSON ISSUING THE FORM MAY RESULT IN DENIAL OF AN APPLICATION FOR A TEXAS
DRIVER’S LICENSE AND/OR CRIMINAL PROSECUTION.
10
P
ARENT
T
AUGHT
D
RIVER
E
DUCATION
D
ESIGNATION
F
ORM
THIS FORM IS REQUIRED IF THE PARENT/ LEGAL GUARDIAN IS NOT THE INSTRUCTOR
Section 1001.112, Education Code, allows a parent, legal guardian or a judge of a court with jurisdiction over the person to
designate an individual to conduct a PTDE course in their place.
Requirements for the instructor you are designating:
❖ Be at least 25 years of age or older
❖ May not charge a fee for conducting the course
❖ Has at least seven (7) years driving experience
❖ Possess a valid driver license for the past three years that has not been suspended, revoked or forfeited
for an offense that involves the operation of a motor vehicle
❖ Has not been convicted (including a probated sentence) of criminally negligent homicide
❖ Has not been convicted (including a probated sentence) for driving while intoxicated in the past 7 years
❖ Not have six or more points assigned to their driver license
Instructors are responsible for checking their criminal and/or driver record to confirm eligibility prior to instructing an
approved PTDE course. If DPS determines the instructor does not meet eligibility the license issuance will be denied.
Any classroom or in-car instruction provided by an ineligible instructor will be voided.
I, , hereby designate ,
(Print Parent / Legal Guardian / Judge Name) (Print Instructor Designee Name)
driver license number , to conduct a TDLR approved PTDE course for my student
(Instructor Designee Driver License Number)
, date of birth .
(Print Student Full Name) (MM/DD/YYYY)
I certify that the above-named student, I am the:
Parent Legal Guardian Judge with jurisdiction over the student
(Parent / Legal Guardian / Judge Signature) (Date)
(Instructor Designee Signature) (Date)
PTDE Instructor Designation Form (12/2017)
TAKE THIS FORM WITH YOU TO THE DEPARTMENT OF PUBLIC SAFETY
11
IN-CAR OBSERVATION & BEHIND-THE-WHEEL INSTRUCTION LOG
Complete the 7 hours of in-car observation
and 7 hours of behind-the-wheel instruction with the Parent Taught
teacher registered with the Texas Department of Licensing and Regulation (TDLR). The curriculum for this log can be
found in the Driving Manager section of your Aceable course. Only one hour of observation or instruction per day can
be counted toward the required 14 hours. You may be asked to present this log to the DPS when applying for your
provisional license.
Student’s Name:___________________________________ Permit #:______________________________
Topic
In-Car Observation
or
Behind-the-Wheel
Instruction
Date
Time
Duration
Official Parent Instructor Signature
and DL#
Driver Preparation,
Starting, Operation,
and Post-Drive
Tasks
In-Car Observation
30 minutes
Behind-the-Wheel Practice
30 minutes
Vehicle Movements
In-Car Observation
60 minutes
Behind-the-Wheel Practice
60 minutes
Driver Readiness
In-Car Observation
60 minutes
Behind-the-Wheel Practice
60 minutes
Environmental
Characteristics &
Risk Factors
In-Car Observation
60 minutes
Behind-the-Wheel Practice
60 minutes
Distractions
In-Car Observation
60 minutes
Behind-the-Wheel Practice
60 minutes
Vehicle Movements
& Reference Points
In-Car Observation
60 minutes
Behind-the-Wheel Practice
60 minutes
Adverse Conditions
& Vehicle
Requirements
In-Car Observation
60 minutes
Behind-the-Wheel Practice
60 minutes
Consumer and
Personal
Responsibility
In-Car Observation
30 minutes
Behind-the-Wheel Practice
30 minutes
TOTAL: 7 hours In-Car Observation + 7 hours Behind-the-Wheel Practice = 14 hours
This form is also referred to as a DL-91B, Appendix F.
12
BEHIND-THE-WHEEL INSTRUCTION LOG
The 30 hours of
behind-the-wheel practice must be completed in the presence of an adult who is 21 years of age or
older and has been licensed for at least one year (TRC 521.222) before the student is eligible for a provisional
license. Only one hour of behind-the-wheel practice per day will count toward the 30 hours regardless of the number
of hours the student actually drives in a day. At least 10 of the 30 hours must be completed at night. You may be
asked to present this log to the DPS when applying for your provisional license.
Student’s
Name:___________________________________ Permit #:______________________________
Practice Session Date Time
Daytime
Hours
Nighttime
Hours
Adult’s Initials and DL#
Getting Ready, Starting,
Placing Vehicle in Motion,
and Stopping (2 hours)
Moving, Stopping,
Steering, Knowing Where
You Are
(3 hours)
Backing (1 hour)
Turning, Lane Position,
and Visual Skills
(4 hours)
Searching Intended Path of
Travel
(3 hours)
Parking (1 hour)
Turnabouts (2 hours)
Multiple Lane Roadways
(4 hours)
City Driving
(5 hours)
Expressway/Freeway
Driving
(5 hours)
This form is also referred to as a DL-91B, Appendix G.
I certify and endorse that the above record is true and correct and my student has completed 30 hours of guided
practice which includes at least 10 at nighttime.
______________________
_________________________ ________________________
Instructor’s Signature (if over 18 years of age, student’s signature) Date
13
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Pre-DPS Trip Guide (City of Oakland)

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