Driver Information

PLEASE PRINT FULL LEGAL NAME

SIGNATURE

DRIVERSED.COM USERNAME

BIRTHDATE TELEPHONE #

AFFIDAVIT OF IDENTITY

You have completed DriversEd.com’s Online Texas Adult 6 Hour Driver Education Course. Now you must provide DriversEd.com with proof of your identity after taking the Final Exam. Before we can issue your Certificate of Completion, you must fill out this form, provide the necessary documentation to a notary, and follow the instructions below to send in this form. Certification

I certify that I have provided the following legal and ORIGINAL documents to the notary listed below:

Photo Identification/Driver's License OR

Original Social Security Card AND Original Birth Certificate OR

A current Passport with photo OR

Foreign Drivers

Another document acceptable to the notary as establishing the identity of the person signing this affidavit 1. By signing this document I certify that I am the person that took this course in its entirety and that I am the person that completed DriversEd.com’s Online Texas Adult 6 Hour Driver Education Course. 2. By signing I certify that I am the person providing the documents above and that they are legal. 3. I have reviewed this form and I affirm that all of the information is correct and true. NOTARY SEAL

DriversEd.com P.O. Box 209, Oakland, CA 94604

888-***-**** 972-***-**** ****@*********.***

FAX THIS FORM TO: 972-***-****

For further information visit www.DriversEd.com or contact us at ****@*********.*** Sworn to and subscribed before me on this

day of, 20 .

Notary Public Signature My commission expires:

Eugene Ngirababyeyi

1/1/1996 281-***-****

************@*****.***

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