Application For Texas Hardship Driver License Page 2

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Explain in detail all necessary driving of minor and why others cannot perform this function: NOTE: TRAVEL TO PARTICIPATE IN SCHOOL ACTIVITIES
SUCH AS BAND, SPORTS, ETC., WILL NOT BE CONSIDERED A SUFFICIENT REASON TO ESTABLISH AN UNUSUAL ECONOMIC HARDSHIP.
(TAC Title 37 §15.28)
If additional space is needed -- attach an additional page
Texas Transportation Code Section §521.223 (e) - A person who is refused a driver license under this section may appeal to the county court of the county
in which the person resides. The court may try the matter on the request of the petitioner or respondent.
Texas Transportation Code Section §521.454 - A person commits an offense if the person knowingly swears to or affirms falsely before a person authorized
to take statements under oath any matter, information, or statement required by the Department in an application for an original, renewal, or duplicate driver
license or certificate issued under this chapter.
TO THE PARENT: In making this application as parent or guardian of
,
I take full responsibility for the authorization of said minor to be issued a driver license. I understand that the Department may make any investigation necessary
to confirm or deny any information contained in this application or information concerning early enrollment authority in a driver education course as provided
in Texas Transportation Code Section 521.223.
I DO SOLEMNLY SWEAR, AFFIRM, OR CERTIFY THAT I AM THE PERSON NAMED HEREIN AND THAT THE STATEMENTS ON THIS
APPLICATION ARE TRUE AND CORRECT. I FURTHER CERTIFY MY RESIDENCE ADDRESS IS A: (
) SINGLE FAMILY DWELLING,
( ) APARTMENT, ( ) MOTEL, ( ) TEMPORARY SHELTER. (check one)
Signature of Parent or Guardian
Signature of Minor
VERIFICATION
SWORN TO AND SUBSCRIBED BEFORE ME THIS
DAY OF
,
Notary Public in and for the state of Texas/Authorized Officer
DO NOT WRITE BELOW THIS LINE -- FOR DEPARTMENT USE ONLY
Application approved this date
Rejected this date
DL-77A issued.
Applicant meets requirements under Texas Transportation Code Section 521.223.
Restrictions:
License number issued:
Application Approved/Rejected (circle one) by
Signature
ID#
JUSTIFICATION:

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