De 964 Form PDF Details

The DE-964 form is an essential document for parent-taught driver education course providers in Texas, mandated and regulated by the Texas Department of Licensing and Regulation (TDLR). This specialized form, exclusively for TDLR staff use, enables course providers to order certificates required to validate the successful completion of a driver education course directly taught by parents. Each form facilitates the acquisition of either hard copy certificates or identifying numbers for printed certificates, with each requested certificate costing $1.00. These completion certificates are critical for students to progress towards obtaining their driver's licenses, marking a significant step in their journey to becoming licensed drivers. The form stipulates that all fees paid for these certificates are non-refundable and that any unused certificates or numbers cannot be transferred, emphasizing the importance of accurate orders. Additionally, the DE-964 form outlines specific instructions for the delivery of hard copies, including a no overnight delivery policy and the inability to ship out-of-state, as well as procedures for walk-in or pick-up services from a designated address in Austin, Texas. Significantly, this document underlines the process for mail-in orders, including payment methods and the address to which the form and payment should be sent, ensuring course providers comprehend the critical steps to fulfill their obligations and support their students' educational needs.

Form NameDe 964 Form
Form Length1 pages
Fillable fields0
Avg. time to fill out15 sec
Other nameswhat does a de 964 form look like, de 964, de964, de 964 form texas

Form Preview Example


- TDLR Parent Taught Course Provider DE-964

PT Course Provider Number:



Number of certs ordered: ______________________________

Prepared by:



Certificate numbers: __________________________________ to ___________________________________

Pick-Up or E-mail date/time:









DE-964 – TDLR Parent Taught Driver Education Certificate Order Form

(For Use by Parent Taught Course Providers Only)



Parent Taught Course Name: _____________________________________________________ CP#


_________ X

$1.00 each







Original Signature of Parent Taught Course Owner


Printed Name




Check one box and enter the applicable address:

HARD COPIES (3-part paper completion certificates ready to issue)

Delivery Address:

Overnight Delivery of hard copies is not available. Out-of-state shipments are not available.

WALK-IN or PICK-UP service from 920 Colorado St., Austin, Texas 78701 will require 72 hours to process. Call (512) 463-6599 for details.

NUMBERS* (Identifying numbers for completion certificates printed and issued by the PT course provider)

*A certificate proof must be submitted and approved by the Texas Department of Licensing and Regulation before certificate numbers will be sold.

E-mail Address:




Certificates: _________ X $1.00 each

Total enclosed


Make check or money order payable to TDLR. Cash is NOT accepted. Mail payment and this original completed and signed order form to:

Texas Department of Licensing and Regulation

P O BOX 12157

Austin Texas 78711

Orders will be processed only when fees and this signed order form have been received by TDLR office. No exceptions.


DE-964 (03/2016)

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Fill out the HARD COPIES part paper completion, Delivery Address, WALKIN or PICKUP service from, Overnight Delivery of hard copies, NUMBERS Identifying numbers for, A certificate proof must be, will be sold, Email Address, MAILIN ORDERS, Certificates X each, Total enclosed, and Make check or money order payable area with the information demanded by the program.

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