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2. Date*
   Date
4. First Name*
5. Last Name*
7. Email Address*
8. Phone*
10. Ticket Number*
11. Violation/Offense*
13. Document Upload

    Any/all documents requiring a signature MUST be signed.

15. Driving Safety Course Certificate
17. To obtain Driver Record (3A)
    Texas.Gov
19. Driver Record (3A)
21. Upon receipt and verification that your Certificate of Completion for the Driving Safety Course and your Driver Record are in compliance with the Judge's Order, a dismissal will be processed.
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23. 1. Receive an email copy of this form.
24. Email address

    This field is not part of the form submission.

25. Submit

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