Form DIC-23 at a glance
What it is: The DIC-23 (Rev. 10/25) is the Peace Officer's Sworn Report, in which a Texas Peace Officer certifies that the following information is true and correct.
Who signs: The Officer's Signature line is marked SIGN.
The form is for a Texas Peace Officer: enter your name after My name is.
A filled-in Form DIC-23 example: a breath test after a stop
How to fill out Form DIC-23, box by box
Your name, the county and the Subject's Name
Enter the COUNTY OF under STATE OF TEXAS.
Enter the Subject's Name: you certify that you had probable cause to believe and do believe that the subject was driving or in actual physical control of a motor vehicle in a public place in Texas while intoxicated or under the influence of alcohol.
A. Contained in report(s) or B. Noted in the following, I. On or about
Facts in support of this belief are: A. Contained in report(s) incorporated by reference for all purposes as if written and copied herein, where you specify the report(s) or document(s), OR B. Noted in the following.
Under B, I. On or about, enter the Date and Time of Offense, the Description of Motor Vehicle or Watercraft, the Observer and the Location (address, including city and county) of the public place.
II. Reasonable suspicion to stop or make contact
Under II, enter the Reasonable suspicion to stop or make contact.
III. The driver was identified to me as, and IV. Probable cause for arrest or detention
Under III, after The driver was identified to me as, enter the Name, Driver License No. and DOB; under IV. Probable cause for arrest or detention, a., enter the Signs of intoxication or consumption of alcohol.
Under b., enter the Sobriety tasks requested, if any, and performance obtained (explain).
Mark I am trained to be proficient in administering standardized field sobriety tests, including or not including horizontal gaze nystagmus.
V. Check one
Under V. Check one, mark one of these: Subject consented to provide a breath specimen with the Intoxilyzer results, Subject refused test, Subject consented to provide a blood sample, results pending, or Subject was a minor and was not requested to provide a specimen.
Signing and Declarant
The Officer's Signature line is marked SIGN.
Enter the Printed Name and the Agency.
Under Declarant, enter your name as First Middle Last and the Name of Law Enforcement Agency: you are an employee of that government agency and are executing this declaration as part of your assigned duties and responsibilities.
You declare under penalty of perjury that it is true and correct; then enter the County in Executed in County, State of Texas, and the day, Month and Year.
Common questions about Form DIC-23
What is the Dic 24 in Texas?
The statutory warning given to the person is set out in detail in the document DIC-24, which is incorporated by reference for all purposes as if written and copied herein.
Sources
[1] Form DIC-23 (Rev. 10/25), Peace Officer's Sworn Report, Texas Department of Public Safety (the Official source link on this page).