Dl 170 Etp Form PDF Details

Understanding the DL 170 ETP form is paramount for individuals participating in the Employer Testing Program (ETP) as it serves as the Certificate of Driving Skill. This document is a crucial piece of the puzzle for drivers seeking to validate their driving competencies under the ETP, which is exclusively meant for them. The form ensures the verification of a driver's skill is documented officially by attesting that the driver has undergone specific training and successfully passed the employer’s driving test. Additionally, it opens the door to the necessity of meeting the standards of the Department of Motor Vehicles (DMV) and, in some cases, may require passing additional tests administred by the DMV to maintain or upgrade one’s commercial license status. Valid for one year from the drive test date, the form must be returned to the DMV, keeping in line with the stipulated guidelines, unless otherwise instructed. It encompasses various sections, including one that must be filled out by the driver, another by the examiner who witnesses and certifies the driving skills, and a segment for the employer’s representative to confirm the employment status and validate the driver's skillset. This intertwined process ensures that all safety and regulatory requirements are met, maintaining high standards within the realm of commercial driving. A careful look at the DL 170 ETP form reveals its importance in the commercial driving sector, emphasizing safety, compliance, and proper documentation.

QuestionAnswer
Form NameDl 170 Etp Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesdl44, dmv dl 44 form pdf, dl44 form, dl 44 form

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CERTIFICATE OF DRIVING SKILL

IMPORTANT, this form to be used by ETP participants only.

A Public Service Agency

170

____ EN ___ - ___ - _____

This certiicate is valid for one year from the drive test date. Return the original copy of this form to a Department of Motor Vehicles (DMV) ofice unless DMV tells you to mail it to Sacramento. Make a copy for your records. If you have questions, please call the Employer

Testing Program Unit at (916) 229-4404.

DRIVER COMPLETES THIS SECTION

PRINT DRIVER’S NAME

(First

Middle

Last)

 

DRIVER LICENSE NUMBER

 

 

 

 

 

 

 

ADDRESS

 

 

 

CITY

STATE

ZIP CODE

 

 

 

 

HOME TELEPHONE NUMBER

 

WORK TELEPHONE NUMBER

EMPLOYMENT DATE WITH THIS COMPANY (REQUIRED)

(

)

 

(

)

SINCE

MO_____ DA_____ YR_____

 

 

 

 

 

 

 

I certify under penalty of perjury under the laws of the State of California that the information I have provided is true and correct. I am employed by the employer named below, have attended driver training and have passed the employer’s driving test(s). I understand that I may be required to pass a DMV administered test, at DMV’s discretion. I also understand that if the employer’s drive test(s) does not meet DMV’s requirements and standards I will be required to retest or my commercial driver license will be downgraded to the previous class.

EXECUTED AT

CITY

COUNTY

DRIVER’S SIGNATURE

X

DATE

EXAMINER COMPLETES THIS SECTION

The driver passed a drive test(s) in the following type vehicle(s) on _________________________.

Class A non-passenger vehicle Class A tractor trailer bus Class B non-passenger vehicle

DATE

Class B bus or van which is:

Class B school bus (school bus mechanics only) which is:

designed to carry 11–15 passengers, including the driver (Restriction 74 or 75)

designed to carry 16 or more passengers, including the driver, with a GVWR of 26,000 lbs. or less (Restriction 76) designed to carry 16 or more passengers, including the driver with a GVWR of 26,001 lbs. or more

The vehicle(s) used for this drive test(s):

 

has an automatic transmission (Restriction 64)

does not have air brakes (Restriction 48)

has an automated transmission (Restriction 65)

is equipped with air brakes (law test required)

has a manual transmission

is a 3-axle vehicle with a GVWR between 6,000–26,000 lbs.

 

(Restriction 79Class B vehicles only)

DMV ROUTE APPROVAL NUMBER

VEHICLE LICENSE NUMBER(S)

TRAILER ID PLATE NUMBER(S)

I certify under penalty of perjury under the laws of the State of California that the information I have provided is true and correct.

I have the appropriate class of commercial license for the test vehicle, and have administered a drive test(s) which meets DMV’s drive test requirements and standards in the vehicle(s) identiied above.

EXECUTED AT

CITY

COUNTY

EXAMINER’S SIGNATURE

DATE

 

X

 

 

EXAMINER’S PRINTED NAME

DRIVER LICENSE NUMBER

EMPLOYER’S REPRESENTATIVE COMPLETES THIS SECTION

I certify under penalty of perjury under the laws of the State of California that the information I have provided is true and correct. I am an authorized representative of the employer shown on this form. The driver named above is employed by this employer and is required to operate Class A or Class B vehicles in the course of his or her employment. This driver has attended the required training, and passed a drive test(s) which meets DMV’s drive test requirements and standards.

EXECUTED AT

CITY

COUNTY

AUTHORIZED REPRESENTATIVE’S SIGNATURE

DATE

 

 

X

 

 

 

 

 

 

 

 

 

 

 

 

AUTHORIZED REPRESENTATIVE’S PRINTED NAME

DRIVER LICENSE NUMBER

 

PHONE NUMBER WHERE REPRESENTATIVE CAN BE REACHED

 

 

 

 

 

(

)

 

EXT.

 

 

 

 

 

 

 

 

 

EMPLOYER NAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EMPLOYER ADDRESS

CITY

 

 

 

STATE

ZIP CODE

 

 

 

 

 

 

 

 

DMV FIELD OFFICE

 

DMV HEADQUARTERS USE ONLY

 

 

 

 

 

 

 

 

 

 

 

PLEASE NOTE: Send this form

 

HEADQUARTERS APPROVAL

 

PREVIOUS CLASS

 

CURRENT CLASS

 

 

 

 

 

 

 

 

directly to the Employer Testing

 

 

 

 

 

 

 

 

 

CO. AUTHORIZATION AT TIME OF CERT.

 

PREVIOUS ENDORSEMENTS

CURRENT ENDORSEMENTS

Program Unit, M/S L224.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EMPLOYEE NAME, ID NUMBER, AND FO NUMBER

 

 

 

PREVIOUS RESTRICTIONS

CURRENT RESTRICTIONS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DL 170 ETP (REV. 9/2006) WWW

 

 

 

 

 

 

 

A Public Service Agency

INSTRUCTIONS FOR COMPLETING THE CERTIFICATE OF DRIVING SKILL

DRIVER

This form is valid one year from the date of the drive test.

If the drive test administered by your employer does not meet DMV requirements and standards, you may be required to retest to retain your commercial license status.

You may be required to pass a DMV administered test at DMV’s discretion.

EMPLOYER

Keep a copy of this form for a minimum of three years from the date the driver is no longer in your employ.

The Certificate of Driving Skill (DL 170ETP) is not required to waive a driving test for a Class B with passenger endorse- ment if the driver holds a valid School Bus Certificate, Student Pupil Activity Bus Certificate, or a General Public Paratransit Vehicle Certificate unless the driver is upgrading or removing restrictions.

A drive test is required for each DL 170ETP issued.

A separate DL 170ETP is required for each class of drive test if drive test dates or examiners are different.

A separate and complete drive test is required to remove a restriction or add a Passenger Endorsement.

Issue a DL 170ETP only to drivers who:

are employed by you at the time the certificate is issued,

have taken the required training, and

have taken a drive test equivalent to DMV’s drive test requirements and standards.

DMV EMPLOYEE

Route the DL 170ETP to the Employer Testing Program Unit at M/S L224. DO NOT send to Micrographics.

Is all required information (i.e., type of drive test(s), restriction(s) required, all dates, signatures, EN number) complete?

DESCRIPTION OF VEHICLE CLASSES

CLASS A Also see “Required Endorsements” listed below

You may drive:

• Any legal combination of Class A, Class B or Class C vehicles if properly endorsed (some restrictions may apply).

You may tow:

Any vehicle or trailer (Class A authorizes towing vehicles or trailers exceeding 10,000 lbs. GVWR).

Double/triple trailers, with endorsement.

A trailer bus, with endorsement.

CLASS B Also see “Required Endorsements” listed below

You may drive:

Any single vehicle with 3 or more axles weighing more than 6,000 lbs. GVWR (some restrictions may apply).

Any single vehicle weighing 26,001 lbs. or more GVWR (some restrictions may apply).

Any bus (except a trailer bus) if properly endorsed (some restrictions may apply).

You may not drive a school bus unless you passed a drive test in a school bus and have a school bus endorsement.

You may tow:

• Another vehicle or trailer under 10,000 lbs. GVWR.

CLASS C

This form cannot be used to qualify for a commercial Class C driver license.

REQUIRED ENDORSEMENTS NOTE: Driver is required to obtain

Double Triple Endorsement — for double and triple trailers.

Passenger Endorsement — for passenger transport vehicles, which include, but is not limited to a bus. (Restrictions may apply depending on size of bus.) NOTE: Mechanics who drive a bus while servicing it, must have a passenger endorsement.

Tank Vehicle Endorsement — For any size permanently attached tank or any portable tank with capacity of over 1,000 gallons.

Hazardous Materials or Hazardous Waste Endorsement — For any vehicle carrying hazardous materials or wastes which must be placarded or as defined in Health and Safety Code §25115 and §25117.

DL 170 ETP (REV. 9/2006) WWW

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