DPS / INSURANCE COPY

TEXAS DRIVER EDUCATION CERTIFICATE CONTROL NO.

(Type or print legibly in black ink) PT 01875266

FOR DRIVER LICENSE ONLY
Parent Taught Driver Education (PTDE) Course Duplicate (Original Control # PT____________________)
Transfer (if applicable) of 32 classroom hours to _____________________________________________________________________
(School name and address – attach proof of successful completion of 32 classroom hours)

Laboratory (In-Car): 7 hours Behind-the-Wheel Instruction and 7 hours In-Car Observation

Name: Flavian , Ryan C Date of Birth: 07 / 06 / 06 Male Female
Last First MI

Learner License #: Classroom Completion: XX / XX / XX Laboratory (In-Car) Completion: / /

I hereby certify that the person indicated has completed and passed both the classroom and the laboratory phase of a Parent Taught Driver Education
course approved by the Texas Department of Public Safety.

PARENT TAUGHT DRIVERS ED

Signature of PTDE Instructor Instructor DL # PTDE Course Name
_________________________________________________ 134
______________________________ 01/09/2023
Signature (Optional) PTDE Course Provider _________________________________
PTDE Course Number Date Issued
___
30 hours behind-the-wheel instruction, including at least 10 hours of instruction that took place at night
I hereby certify that the person indicated has completed the additional behind-the-wheel instruction in the presence of an adult who meets
the requirements of Section 521.222(d)(2), Transportation Code.
________________________________________________ _______________________________________ _____________________________________________
Signature of Instructor Instructor DL # 30 hour BTW completion date

WARNING: You may commit a crime if you present this certificate to the DPS and you did not complete the course of hours as indicated. You may also commit a
crime if you put any information on this certificate that is not true.

UNLAWFUL IF REPRODUCED OR ALTERED PT DE-964E (Rev 05/2015)

↑ This portion must be presented to DPS for issuance of a Driver License ↑

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↓ This portion must be presented to DPS for issuance of a Learner License ↓

TEXAS DRIVER EDUCATION CERTIFICATE CONTROL NO.

DPS / INSURANCE COPY
(Type or print legibly in black ink) PT 01875266
FOR LEARNER LICENSE ONLY
Parent Taught Driver Education (PTDE) Course Duplicate (Original Control # PT____________________)

Concurrent Program * (classroom and laboratory provided simultaneously) Block Program (entire classroom phase completed before laboratory begins)
* Under the concurrent program, if a student does not complete the required classroom instruction, the instructor is required to complete Parent Taught Cancellation Form (DL-93) and send it to the License and Record
Service at the Texas Department of Public Safety. The DPS may then revoke the student’s learner license.

Name: Flavian , Ryan C Date of Birth: 07 / 06 / 06 Male Female

Last First MI
Must take Class–Road Rules and Class C–Signs examinations with the Department of Public Safety
XXX
Has passed Class C–Road Rules and Class C–Signs examinations. Grade: Road Rules ________ XXX and
Road Signs ________
Must take vision exam with the Department of Public Safety
I hereby certify that the person indicated has completed and passed at least six (6) hours of driver education traffic laws and is enrolled in a Parent
Taught Driver Education course approved by the Texas Department of Public Safety.
PARENT TAUGHT DRIVERS ED
Signature of PTDE Instructor Instructor DL # PTDE Course Name
_________________________________________________ 134
______________________________________ 12/31/1969
_____________________________
Signature (Optional) PTDE Course Provider PTDE Course Number ______________
Date Issued

WARNING: You may commit a crime if you present this certificate to the DPS and you did not complete the course of hours as indicated. You may also commit a
crime if you put any information on this certificate that is not true.

UNLAWFUL IF REPRODUCED OR ALTERED PT DE-964E (Rev 05/2015)