Driving Safety Request

You may be able to request that one charge (moving violation only) be dismissed by successfully completing a driving safety course or a motorcycle operator training course. You may lose that right, on or before your appearance date, if you do not provide the Court with the completed application of your request to take the course. You may email this to court@woodwaytexas.gov or Fax to (254)776-5178.

Name (Print or type as it appears on your driver's license)*

First NameLast Name

Citation No.*

Violation*

Address*

Street Address

Street Address Line 2

CityState

Zip Code

Email*

example@example.com

Telephone Number*

Defendant's Plea:

GUILTYNO CONTEST

ALL LINE ITEMS BELOW MUST BE INITIALED:*

I hereby plea GUILTY or NO CONTEST (select plea above)I possess a valid Texas driver’s license or permit. I do not hold a CDL license.I have not taken a driving safety course in lieu of paying a fine during the past 12 months (class date to violation date).I am not in the process of taking a course that is not yet reflected on my driving record.I understand I cannot take the driving safety course in lieu of paying the fine if I am accused of speeding 25 milesan hour or more over the posted speed limit or cited in a construction zone when workers are present.I am providing a copy my vehicle insurance certificate with this application.I am providing payment with this application to Woodway Municipal Court in the amount of $144 or if violation occurredin a school zone amount of $169. If I decide to mail my application, I understand I need to mail it certified. You will onlypay to the Court $144 or $169 if the offense occurred in a school zone.I understand that I have 90 days to complete a driver safety (defensive driving) course approved by the Texas Departmentof Licensing & Regulations www.tdlr.texas.gov and to provide the court with the original class certificate showingsuccessful completion of the driving safety course. Your signature is required on the certificateI understand that I have 90 days to request a certified copy (form 3A) of my driving record from the Department of PublicSafety and to submit it to the court. Order online at www.texas.gov

I, Type full name* confirm that on the date of my request for a driving safety course/motorcycle operator training course in the above numbered cause that I was not taking such a course nor had I completed one within the 12 months preceding the date of my current offense that is not shown on my driving record as maintained by the Texas Department of Public Safety (or as maintained by the state that issued my driver’s license - active military duty personnel only).

Defendant's Signature*

Date*

Date

DRIVING SAFETY COURSE REQUEST