Form Center

2. Before requesting a DRIVING SAFETY COURSE, click here for eligibility and requirements.
   https://www.celina-tx.gov/569/Drivers-Safety-Course
4. First Name *
5. Last Name*
7. Ticket Number*
8. Violation/Offense*
10. Street / PO Box*
12. City*
13. State*
14. ZIP*
16. Email Address*
17. Phone*
19. Texas Driver's License (CDL does not qualify)*

    Note:  If you do not have a valid Texas Driver's License or permit and are a member, or spouse or dependent child of a member of the United States military forces serving on active duty, upload proof here.

20. Insurance *
22. I hereby enter my appearance on the complaint of the offense stated above. I understand that I have a right to a jury trial. I elect under Article 45.0511, Code of Criminal Procedure, to take a driving safety course.
24. I waive my right to a jury trial and enter my plea of*
    -- Select One --No ContestGuilty
26. ELIGIBILITY

    To be eligible for a Driving Safety Course, Statements 1 - 11 must be checked confirming you have read and understand the following statements:

28. (1) a valid Texas driver’s license or Texas permit, or proof that I am a member, or the spouse or dependent child of a member, of the United States military forces serving on active duty;*

    1. I understand proof must be presented with this request.
30. (2) proof of financial responsibility (Insurance) pursuant to Chapter 601, Transportation Code (automobile liability insurance);*

    1. I understand proof must be presented with this request.
32. (3) court costs and administrative fee $144 [SCHOOL ZONE $169]; *

    1. I understand
34. (4) complete a driving safety course or motorcycle operator training course as applicable within 90 days;*

    1. I understand
36. (5) submit by the 90th day a Texas State-approved Certificate of Completion;*

    1. I understand
38. (6) not currently be taking such a course or completed one for another ticket within the preceding 12 months from the date of this offense;*

    1. I understand
40. (7) submit by the 90th day a certified copy of my driving record as maintained by the Texas Department of Public Safety;*

    1. I understand
42. (8) if I comply with the court order, the Court will dismiss my case and report to the Texas Department of Public Safety the date that I completed my course for inclusion on my driving record;*

    1. I understand
44. (9) if I fail to submit all the evidence required, I will be notified of a show cause hearing and be required to appear before the Judge to show cause why I did not comply with the Judge's Order;*

    1. I understand
46. (10) the Judge may at the show cause hearing enter a final adjudication against me and require me to pay the fine; *

    1. I understand
48. (11) the failure to appear at the show cause hearing will result in a final adjudication against me, and that I will be required to pay the fine and any additional costs required by law.*

    1. I understand
50. I attest that I am the individual who received the citation referenced above. I have read the document and on the date of this request for a driving safety course/motorcycle training course in the above-numbered cause, I am not taking such a course nor have I completed one within the 12 months preceding the date of this offense and that a driving safety course is not shown on my driving record as maintained by the Texas Department of Public Safety (or as maintained by the state that issued my driver’s license – active military duty personnel only).
52. Payment Information*
    -- Select One -- I agree to pay $144 (SCHOOL ZONE $169) online within 30 days. Online payment information will be provided with the Court's Order. I agree to mail a check or money order payable to Celina Municipal Court within 30 days.
54. Interim Judgment (DSC) Order

    DO NOT make payment, obtain driver record, or take a driving safety course (DSC) prior to being ordered to do so by the Court.  Should your request for driving safety course be granted, you will receive a copy of the Interim Judgment (DSC) Order via email.  Your signature is NOT required on this document.  You must read and comply with the Court's Order within the timeframe specified on the Order.

56. Processing

    Allow the court 1-3 BUSINESS DAYS for processing.  CHECK YOUR EMAIL.  If you do not receive a response via email from the court within 1-3 BUSINESS DAYS, it is your responsibility to follow up with the Court.

58. Defendant Signature*
    By typing my name, I adopt this as my signature and have read, affirm and agree to the information herein.
59. Date*
    Date
61. Confirmation

    Enter the email address below in which to receive a copy of submittal to the Court.

Leave This Blank:


63. 1. Receive an email copy of this form.
64. Email address

    This field is not part of the form submission.

65. Submit

* indicates a required field