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

 

 

May 19, 2024

 

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Signature Certificate
Document name: Driver Improvement Waiver
lock iconUnique Document ID: 62aabd47850b7d1f4e60e0b7ca12266ad0e593e2
Timestamp Audit
December 1, 2020 2:42 pm EDTDriver Improvement Waiver Uploaded by Premier Driving School, Inc - service@premierdriversed.com IP 100.16.3.192
February 8, 2023 4:51 pm EDTDavid Barnes - service@premierdriversed.com added by Premier Driving School, Inc - service@premierdriversed.com as a CC'd Recipient Ip: 100.16.3.192
February 1, 2024 1:24 pm EDTDavid Barnes - service@premierdriversed.com added by Premier Driving School, Inc - service@premierdriversed.com as a CC'd Recipient Ip: 100.16.3.192