Form Center

2. 
   
4. CAUSE NUMBER
6. STATE OF TEXAS
   VS
   DEFENDANTS NAME
   
7. IN THE MUNICIPAL COURT
   CITY OF WATAUGA
   TARRANT COUNTY, TEXAS
9. Last Name*
10. First Name*
12. Address line 1*
14. Address line 2
16. City*
17. State *
18. Zip Code*
20. Phone Number *
22. 
    
24. REQUEST FOR A DRIVING SAFETY COURSE
26. 
    
28. I hereby enter my appearance under Art. 45.0511(b)(1) of the Code of Criminal
    Procedure on the complaint of the offense of
30. Name of violation: *
    -- Select One --BlankSPEEDING 1-14 OVER SPEEDING IN A SCHOOL ZONE 1-14 OVERSPEEDING IN A PARK ZONE 1-14 OVERRAN A STOP SIGN RAN RED LIGHT CUTTING ACROSS A PARKING LOTHANDHELD MOBILE PHONE (CELL PHONE IN SCHOOL ZONE)TURNED RIGHT FROM WRONG LANE TURNED LEFT FROM WRONG LANE CHANGE LANE WHEN UNSAFESPEEDING 15-24 OVER
32. 
    
34. I understand that I have a right to a jury trial. I hereby waive my right to a
    jury trial, plead (guilty)(nolo contendere) and request to take a driver safety
    course.

    1. guilty
    2. nolo contendre
36. 
    
38. I understand that I must, within 90 days of this request:
40. 
    
42. 1. Present to the court a valid Texas Driver's license;

    2. Present to the court proof of financial responsibility (vehicle liability
    insurance);

    3. Present to the court a certified copy of my driving record from the Department of Public Safety;

    4. Take a driver safety course approved by the Texas Education Agency or, if operating a motorcycle, a motorcycle operator's training approved by the DPS;

    5. Present to the court a uniform certificate of driver safety course completion from a Texas Education Agency approved course (or from a DPS
    approved motorcycle course);

    6. Pay court costs and a non-refundable administrative fee of $10.00 fee to the court.
44. 
    
46. I understand that:
48. 
    
50. 1. If I complete a driving safety course within 90 days, the charge against me will be dismissed and the court will report to DPS the completion date of the driver safety course for inclusion on my driving record;

    2. If I fail to present to this court proof of completion of the driver safety course within 90 days, the court will require my appearance at a
    show cause hearing;

    3. If I fail to appear at the show cause hearing, the court will impose the fine and may issue a capias pro-fine warrant for my arrest.

    4. I do not hold a comercial drivers license.
    
52. 
    
54. Defendant's Signature
55. Date
56. Completion Date
58. 
    
60. AFFIDAVIT
62. 
    
64. I,
65. , state under oath that on the date I requested
    to take the driver safety course, I was not in the process of taking a driver
    safety course under Art. 45.0511 of the Code of Criminal Procedure, nor had I
    completed a course under that section that was not yet reflected on my driving
    record as maintained by the Texas DPS.
67. Defendant's Signature
69. 
    
71. Sworn and Subscribed before me, on this the ____ day of ____________, 20_____.

    ____________________________________________
    Notary Public In and For The State of Texas
    
73. Notary Seal
Leave This Blank:


74. Print Only

* indicates a required field