TEXAS TOW ID CARD APPLICATION

TEXAS TOW ID CARD APPLICATION

This form must be submitted in person with required supporting documents for processing. Completing this form will generate a PDF document that must be used for submission along with the supporting documents.
- Applicant Email*
  example@example.com
- Tow OperatorTow Assistant
- NewRenewalChange
- Application Date*
  
  MonthDayYear
  Date
- Applicant TX Driver License Number*
- Applicant TDLR Incident Management Towing Operators License*
- Applicant TDLR License Issue Date*
  
  MonthDayYear
  Date
- Applicant TDLR License Expiration Date*
  
  MonthDayYear
  Date
- Applicant Last Name*
- Applicant First Name*
- Applicant Middle Name
- Applicant Date of Birth*
  
  MonthDayYear
  Date
- Applicant Gender*
- Applicant Height (Inches)*
  Example: Type 66 for 5'6"; 72 for 6'0"; 78 for 6'6"; etc.
- Applicant Weight (Pounds)*
- Applicant Eye Color*
- Applicant Hair Color*
- Applicant Home Phone Number
  Format: (000) 000-0000.
- Applicant Cell Phone Number*
  Please enter a valid phone number.Format: (000) 000-0000.
- Applicant Address*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Towing Company*
- Towing Company Address*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Have you been convicted with the past three years of any of the following offenses?
  - A serious traffic violation
  - leaving the scene of an accident
  - a violation of law that regulates the operation of a motor vehicle at a railroad crossing
  - driving a motor vehicle under the influence of alcohol or controlled substance
  - using a motor vehicle in the commission of a felony
  - causing the death of another person through the negligence or criminal operation of a motor vehicle
  - driving a motor vehicle while license was revoked, suspended, cancelled or while otherwise disqualified from driving
  A conviction of any of the above could result in denial of the tow card. A Criminal History Check will be conducted during the application approval process.
- YesNo
- Enter your initials confirming you have not been convicted
- A serious traffic violationLeaving the scene of an accidentA violation of law that regulates the operation of a motor vehicle at a railroad crossingDriving a motor vehicle under the influence of alcohol or controlled substancesUsing a motor vehicle in the commission of a felonyCausing the death of another person through the negligence or criminal operation of a motor vehicleDriving a motor vehicle while license was revoked, suspended, cancelled or while otherwise disqualified from driving
- The applicant is not addicted to the use of alcohol, controlled substance or another drug that renders a person incapable of driving, an applicant has not refused to submit to a test during the last year to determine alcohol concentration or the presence of a controlled substance/drug while operating a commercial motor vehicle.
  Enter your initials
- Analysis during the last year of the applicant's blood, breath, or urine under TEX, TRANSP. CODE 522, 524, or 724 would not disqualify the applicant from driving a commercial vehicle.
  Enter your initials
- Applicant does not hold a driver's license issued by another State or another country that has been revoked, cancelled or suspended.
  Enter your initials
- Applicant has not been determined by a judgement of a court to be mentally incompetent, unless declared restored to competency by a court or certificate of competency issued by an attending hospital physician
  Enter your initials
- Applicant does not have any mental or physical disability that prevents the person from exercising reasonable and ordinary control over operation of a Tow Truck.
  Enter your initials
- The applicant agrees to indemnify and hold harmless Brazoria County against any claim of damage to a motor vehicle towed, or the contents thereof, and against any injury or damage to any person or another vehicle as a result of non-consent towing services performed by applicant.
  
  Applicant acknowledges that failure to notify the Department within 20 days of change of employer may result in suspension or revocation of operator's permit.
- FALSIFYING ANY GOVERNMENT DOCUMENT IS A CRIME AND WILL BE PROSECUTED
- Should be Empty: