Driver Improvement Waiver


DRIVER IMPROVEMENT PROGRAM

Participant Waiver and Release

 

Participant Soundex Number (Driver's License Number)

 

Participant Name:    

Participant Date of Birth:                             

 

 

By my signature below, I acknowledge that:

  • I am participating in the Driver Improvement Program because the Maryland MVA or another state motor vehicle is requiring my participation or I am participating voluntarily.
  • I understand that it is preferable to provide my MVA assignment letter but it is not required.
  • Electronic certification of completion of this program is based solely on the accuracy of the
    information I provided to the Driver Improvement Program provider on this form; and
  • I have been provided a copy of the Driver Improvement Program Participant Roles and
    Responsibilities; and
  • I fully understand my responsibility in assuring that my driving record properly reflects my
    completion of this program

 

 

August 5, 2021

 

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Signature Certificate
Document name: Driver Improvement Waiver
lock iconUnique Document ID: a86551aea84951b72a2813e9aeebcccb2e558c4e
Timestamp Audit
December 1, 2020 2:42 pm EDTDriver Improvement Waiver Uploaded by Premier Driving School, Inc - service@premierdriversed.com IP 100.16.21.104