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610 W 5TH STREET, SUITE 603 • AUSTIN, TX • 78701 • ACEABLE.COM

1

Learner License - DPS Checklist

We know you're super excited, but before you go to the DPS, make sure you already have your Parent

Taught

Drivers Ed packet. If you missed this step, order the packet at

Proof of Identity & Lawful Presence

You can either provide:

1 Primary Document

Texas ID, US Passport, or US Citizenship

Certificate

-OR-

A Birth Certificate AND 2 of the Items Below

Social Security Card, Immunization Records*,

Hospital-Issued Birth Record*, Medicare or

Medicaid Card*, Report Card, Photo ID Card*.

*Documents must be issued by an institution, entity, or government agency from a US state or territory.

Proof of Texas Residency

Bring two of the following:

Mortgage Statement, Utility Bills, Deed, Report

Card, W-2

Note: Both documents must show same name and

address, be dated within 30 -90 days, and come from two different sources. The name needs to be your official parent instructor's name.

Don't have two proofs? You can sign the Texas

Residency Affidavit (DL-5) from your packet.

Proof of Social Security

Bring your Social Security card.

DE-964 Certificate from Aceable

Verification of Enrollment (VOE) Form

Get this filled out and signed by a school

administrator. It expires after 30 days!

Learner License Application Fee

$16 payable by cash, credit, check, or money order

Thanks for being part of the Aceable family!

Questions?

hat online at Aceable.com

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(: : vJ@;N NZ;v"Z @;z"®?" ®•XK"Z : $"Z"Ky z"Z%;"y %$J% (Instructor's Legal Name) (Driver License Number) the following information contained in this form is true and correct. I am the instructor of , whose (Student's Legal Name) date of birth is , thereby meeting the age requirement to obtain a Class C learner license. (MM-DD-YYYY) I certify that for the above-named student, I am the: Parent Legal guardian Step-parent Step-grandparent Foster parent

Grandparent I acknowledge if one of the above relationships doesn't apply, then by law, I'm not authorized to teach

Parent Taught Drivers Education.

I certify that I:

1.Have submitted the $20 fee to enroll in the Texas Department of Licensing and Regulation's Parent Taught Driver Education

Program

prior to beginning any instruction.

2.Possessed a valid driver license for the preceding three years;

3.Have not been convicted of Criminally Negligent Homicide;

4.Have not been convicted of Driving While Intoxicated;

5.Have not had my driving privileges suspended, revoked or forfeited in the past three years;

6.Had less than six surcharge points assigned to me at the time I began instructing the above-named student; and

Completion Date

6 hours of classroom instruction under the Concurrent Driver Education Program

Completion Date

Title of TDLR-Approved PTDE Training Course: Course Number:

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NOTE: 1®" J"";NJv;% ;? Z" - •;Z"N "#Z "Jz$ ;®?%Z•z%#Z w$# %J•j$% J ?%•N"®% ;® "Jz$ &$J?" #" %$" z#•Z?"n (" %$"Z" ;? X#Z" %$J® #®" ;®?%Z•z%#Z: %$;?

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Date Classroom Instruction Began:

Date Classroom Instruction Completed:

Name of TDLR-Approved Course (which was utilized):

NOTICE: The classroom portion of the course may not be completed in less than 16 calendar days. An instructor may not

provide more than two hours of classroom instruction in any one day.

The classroom instruction must be taught in the following module sequence, and the dates of the instruction must be recorded.

Module Minimum Hours

Required

Hour Date of Instruction

Module 1: Texas Driver Responsibilities - Knowing Texas Traffic Laws

6 Hours

(360 Minutes) R#•Z r

Hour 2

Hour 3

Hour 4

Hour 5

Hour 6

Module 2: Texas Driver Responsibilities - Preparing to Operate a Vehicle

2 Hours

(120 Minutes) R#•Z r Hour 2 Module 3: Basic Maneuvering Tasks - Vehicle Movements

2 Hours

(120 Minutes) R#•Z r Hour 2

Module 4: Driver Readiness

2 Hours

(120 Minutes) R#•Z r Hour 2

Module 5: Information Processing - Risk Reduction

2 Hours

(120 Minutes) R#•Z r Hour 2

Module 6: Environmental Factors

2 Hours

(120 Minutes) R#•Z r Hour 2

Module 7: Distractions

2 Hours

(120 Minutes) R#•Z r Hour 2

Module 8: Alcohol and Other Drugs

6 Hours

(360 Minutes) R#•Z r

Hour 2

Hour 3

Hour 4

Hour 5

Hour 6

Module 9: Adverse Conditions

2 Hours

(120 Minutes) R#•Z r Hour 2

Module 10: Vehicle Requirements

2 Hours

(120 Minutes) R#•Z r Hour 2

Module 11: Consumer Responsibility

2 Hours

(120 Minutes) R#•Z r Hour 2

Module 12: Personal Responsibility

2 Hours

(120 Minutes) R#•Z r Hour 2 TOTAL

32 Hours

(1,920 Minutes)32 Hours

You will be required to present this form at the driver license office when the student applies for a learner license and provisional

license. '9IDrA cW"vn vfrmk

Concurrent Driver Education Program: 2$" ?%•N"®% XJy J&&@y "#Z J®N #K%J;® J @"JZ®"Z @;z"®?" "Z#X %$" 2"xJ? '"&JZ%X"®% #" 5•K@;z FJ""%y •&#®

?•zz"??"•@ z#X&@"%;#® J®N XJ?%"Zy #" 4#N•@" 1®"n 2$;? X•?% ;®z@•N" J X;®;X•X #" ?;x $#•Z? #" z@J??Z##X ;®?%Z•z%;#® "#Z 4#N•@" 1®"n

Block Driver Education Program: 2$" ?%•N"®% X•?% z#X&@"%" J®N XJ?%"Z J@@ #" %$" X#N•@"? cJ X;®;X•X #" bm z@J??Z##X ;®?%Z•z%;#® $#•Z?k K""#Z"

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Under no circumstances may any behind-the-wheel instruction be permitted until a learner license has been issued to the student by the Texas

Department of Public Safety. (®?%Z•z%#ZÕ? /JX"E (®?%Z•z %#ZÕ? 2"xJ? 'Z;v"Z

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EXAMPLE ONLY

Appendix L

TexasResidency

Aĸdavit

Instructionsforcompletionareonbackofform

To )6#

A.ApplicantInformation

;$4"

ResidenceAddressCityStateZIPCode

Applicant'sSignatureDate

that

B.IndividualorRepresentativeInformation

;$4"ofIndividualorRepresentative The The

Certifier'sSignatureDate

DLͲ5(Rev.2/13)

EXAMPLE ONLY

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