The Texas DL-77 form is an application for a Hardship Driver License, designed for individuals facing unusual economic hardship or other qualifying circumstances. This license allows applicants to obtain driving privileges under specific conditions that may include family illness or enrollment in a vocational education program. Completing this form accurately is crucial; any errors could delay the application process.
To begin your application, please fill out the form by clicking the button below.
The Texas DL-77 form is an essential document for individuals seeking a Hardship Driver License in the state of Texas. This form serves as an application for those who find themselves in unique situations where not having a driver’s license could lead to significant economic hardships, medical emergencies, or the need for transportation to vocational education programs. Applicants must fill out the form completely in ink, ensuring that all required information is accurate and legible. Key details include personal identification, contact information, and specific circumstances that justify the need for a hardship license. For instance, applicants may need to provide evidence of family illness or enrollment in a vocational program. Additionally, the form includes sections for medical history and emergency contact information, highlighting the importance of safety and preparedness. It is crucial to note that the Texas Department of Public Safety (DPS) has strict policies regarding application processing, including a 90-day holding period and a no-refund policy once payment is submitted. Understanding these elements can help streamline the application process and increase the likelihood of approval.
DL-77 - TEXAS HARDSHIP DRIVER LICENSE CARD APPLICATION
NOTICE: All information on this application must be in INK. Applications held for 90 days only.
DPS CANNOT REFUND PAYMENT ONCE APPLICATION IS SUBMITTED.
FOR DEPARTMENT USE ONLY
Class (select one):____C ____M
ASSIGNED # _______________________
The Texas Department of Public Safety may issue a driver license to a person who complies with the requirements for the Hardship License if (1) the failure or refusal to issue the license will result in an unusual economic hardship for the family of the applicant, (2) the license is necessary because of the illness of a member of the applicant’s family, or (3) a license is necessary because the applicant is enrolled in a vocational education program and requires a driver’s license to participate in the program. The completion of an approved course in driver education is required. Texas Transportation Code 521.223 and 521.224
APPLICANT INFORMATION
Last Name:_________________________________________ First Name:_________________________________________ Middle Name: ___________________________
Suffix:__________________________________ Birth Surname
( Maiden):_________________________________________
-
SSN:________________________________
Date of Birth (mm/dd/yyyy):_____________________
Sex (select one): ___ Male
___ Female
Height: ______ Ft.
______ In.
Weight: __________ Lbs.
Eye Color (select one): ____ Blue
____ Brown
____ Gray
____ Hazel
____ Green
____ Black
____ Maroon
____ Pink
Hair Color (select one):
____ Red
____ Blonde
____ Bald
____ White
Race (select one): ____ (AI) Alaskan or American Indian
____ (AP) Asian or Pacific Islander
____ (BK) Black
____ (W) White
Ethnicity (select one):
____ (H) Hispanic Origin
____ (O) Not of Hispanic Origin ____ (U) Unknown
Place of birth: City:_______________________________________
State: _____
County:________________________ Country: ___________________________________________
Father’s Last Name:_________________________________________________________
Mother’s Maiden Name: ____________________________________________
CONTACT INFORMATION
Residence Address:_______________________________________________________________________________________________________________________
City:_______________________________________________________ State: _______ Zip Code:____________ County: _______________________________________
Mailing Address: __________________________________________________________________________________________________________________________
Home Phone:________________________ Other Phone:________________________ Email: _____________________________________________________________
In the event of injury or death would you like to provide up to two (2) emergency contacts? If yes, please list:
a)Name ____________________________________ Phone Number __________________ Address _________________________________________________________
b)Name ____________________________________ Phone Number __________________ Address _________________________________________________________
REQUIRED INFORMATION FROM ALL APPLICANTS
YES NO
1.
___
Are you a citizen of the United States?
2.
Do you have a health condition that may impede communication with a peace officer? (physician must complete form DL-101).
3.
Would you like to register as an organ donor?
4.
Do you want to donate $1.00 to the Blindness Education Screening and Treatment Program?
5.
Do you want to support the Glenda Dawson Donate Life Texas donor registry? If yes, please indicate a donation amount of $1 or more
$_______.00.
6.
Do you want to support Texas Veterans? If yes, please indicate a donation amount of $1 or more $_________.00.
7.
Do you want to support survivors of sexual assault? If yes, please indicate a donation amount of $1 or more $_________.00 to help fund the testing
of sexual assault evidence collection kits (rape kits).
8.
Do you want to support the issuance of a DL/ID for foster or homeless youth? If yes, please indicate a donation amount of $1 or more
$_________.00 to exempt this population from paying any fees.
REQUIRED INFORMATION FROM DRIVER LICENSE APPLICANTS ONLY (FOR CONFIDENTIAL USE OF THE DEPARTMENT ONLY)
MEDICAL HISTORY QUESTIONS
1. ___ ___ Do you currently have or have you ever been diagnosed with or treated for any medical condition that may affect your ability to safely operate a motor vehicle? Examples, including but not limited to: Diagnosis or treatment for heart trouble, stroke, hemorrhage or clots, high blood pressure, emphysema (within the past two years) • progressive eye disorder or injury (i.e., glaucoma, macular degeneration, etc.) • loss of normal use of hand, arm, foot or leg • blackouts, seizures, loss of consciousness or body control (within the past two years) • difficulty turning head from side to side • loss of muscular control
•stiff joints or neck • inadequate hand/eye coordination • medical condition that affects your judgment • dizziness or balance problems • missing limbs Please explain and identify your medical condition: ____________________________________________________________________________________________________________
Do you have a mental condition that may affect your ability to safely operate a motor vehicle? If yes, how? Please explain:
________________________________________________________________________________________________________________________________________________________________________
Have you ever had an epileptic seizure, convulsion, loss of consciousness, or other seizure?
Do you have diabetes requiring treatment by insulin?
Do you have any alcohol or drug dependencies that may affect your ability to safely operate a motor vehicle or have you had any episodes of
alcohol or drug abuse within the past two years?
Within the past two years have you been treated for any other serious medical conditions? Please explain:
Have you EVER been referred to the Texas Medical Advisory Board for Driver Licensing?
DL-77 (Rev. 7/2020)
APPLICATION CONTINUED ON BACK
VEHICLE REGISTRATION AND INSURANCE INFORMATION
Do you own a motor vehicle that is required to be registered? (Texas Transportation Code section 502.040)
Do you own a motor vehicle that is required to have liability insurance OR other proof of financial responsibility in compliance with the Motor
Vehicle Safety Responsibility Act? (Texas Transportation Code section 601.051)
APPLICANT IS APPLYING FOR A HARDSHIP DRIVER LICENSE UNDER THE FOLLOWING PROVISION(S):
____ 1.
An unusual economic hardship on the family of the minor.
____ 2.
A death-related emergency: Name of Deceased: ______________________________________________________________________________________________
Date of Death:________________
Relationship to Deceased: _________________________________________________________________________________
____ 3.
Sickness or illness or disability of family members (PHYSICIAN’S STATEMENT REQUIRED)
Name of Family Member:_______________________________________________
Relationship:_______________________________________________________
Family Physician:______________________________________________________
Phone Number: ____________________________________________________
____ 4.
Enrollment in a Vocational Education Program (CERTIFICATION FROM SCHOOL REQUIRED)
School:_______________________________________________________________
Address of School:____________________________________________________
City: ______________________________________________________________
Time Classes: Start:______________ End:______________
Days: ___ MON
___ TUES
___ WED ___ THUR ___ FRI ___ SAT ___ SUN
ADDITIONAL INFORMATION
Does the applicant have a Texas Learner License, Provisional license or ID card? ___ YES
___ NO
If YES, # _____________________________________________
Has the applicant ever applied for a Hardship Driver License? ___ YES ___ NO Where? ________________________________________________________________
Has the applicant completed a required driver education course? ___ YES ___ NO (Choose one) ___ Classroom ___ Driving ___ Both
FATHER’S NAME:___________________________________________________________ License Number:______________________________________
Employed by:______________________________________ Address: _______________________________________________________________________________________
Work Hours:______________________________________ Work Phone:______________________________________
MOTHER’S NAME:___________________________________________________________ License Number:______________________________________
List all other members of the household: (Use extra page if necessary.)
Name:______________________________________________________ License #:________________________________ Relationship: ______________________________
Explain all necessary driving of applicant and why others cannot perform this function: NOTE: TRAVEL TO PARTICIPATE IN SCHOOL ACTIVITIES SUCH AS BAND,
SPORTS, ETC., WILL NOT BE CONSIDERED A SUFFICIENT REASON TO ESTABLISH AN UNUSUAL ECONOMIC HARDSHIP. (TAC Title 37 §15.28)
Use extra page if necessary.
Texas law requires the Texas Department of Public Safety to provide every minor applicant (under age 18) and cosigner, for a driver license in Texas, educational information concerning state laws relating to distracted driving, driving while intoxicated, driving by a minor with alcohol in the minor’s system, and the implied consent law. The minor applicant and cosigner must acknowledge receipt of this information prior to issuance of any driver license or permit.
I hereby acknowledge receipt of this information.
_______________________________________________________________
__________________________
Minor Applicant
Parent/Legal Guardian
Date of Receipt
PARENTAL AUTHORIZATION
TO THE PARENT: In making this application as parent or guardian of _________________________________________________________________ ,
I take full responsibility for the authorization of said minor to be issued a driver license. I understand that the Department may make any investigation necessary to confirm or deny any information contained in this application or information concerning early enrollment authority in a driver education course as provided in Texas Transportation Code section 521.223.
_________________________________________
Usual Written Signature of Parent or Guardian
Driver License Number
Date
NOTICE: The information on this application is required by the Texas Driver License Act, Texas Transportation Code Chapter 521. Failure to provide the information is cause for refusal to issue a driver license or identification card, and in some cases, cancellation or withdrawal of driving privileges. False information could also lead to criminal charges with penalties of a fine up to $4,000.00 and/or jail.
SOCIAL SECURITY NUMBER COLLECTION DISCLOSURE
Disclosure of your social security account number is mandatory for identification card and driver license applicants, but voluntary for election identification certificate applicants. This information is solicited pursuant to 42 U.S.C. section 405(c)(2)(C)(i), 42 U.S.C. section 666(a)(13)(A), 6 C.F.R. section 37.11(e), 49 C.F.R. section 383.153, Texas Family Code section 231.302(c)(1), and Texas Transportation Code sections 521.142 and 522.021. The Department will use social security number information for identification purposes and will only release the number as statutorily authorized by Texas Transportation Code section 521.044.
DO NOT WRITE BELOW THIS LINE – FOR DEPARTMENT USE ONLY
Application (Select one): ___ Approved ___ Rejected _____________________________________________________________
________________
_________________
Signature
ACID#
JUSTIFICATION /RESTRICTIONS:______________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
After gathering the necessary information, you are ready to fill out the Texas Form DL-77. This form is important for those applying for a hardship driver license in Texas. Make sure to complete it in ink and provide accurate details. Once you finish, you will submit the form to the Texas Department of Public Safety.
The Texas DL-77 form is an application for a Hardship Driver License. This type of license may be issued to individuals who can demonstrate that not having a driver's license would cause unusual economic hardship for their family, is necessary due to a family member's illness, or is required for participation in a vocational education program. It is essential to complete the form accurately and submit it to the Texas Department of Public Safety (DPS).
Eligibility for a Hardship Driver License is based on specific criteria. Applicants must meet one of the following conditions:
Additionally, applicants must have completed an approved driver education course.
Applicants must provide various personal details, including:
It is important to fill out the form in ink and ensure that all information is accurate.
No, the Texas Department of Public Safety does not offer refunds for application fees once the application has been submitted. It is crucial to ensure all information is correct and complete before submission to avoid rejection.
After submission, the application will be reviewed by the Department of Public Safety. They will determine whether to approve or reject the application based on the information provided. Applicants will be notified of the decision, and if approved, further instructions will be given on obtaining the Hardship Driver License.
If you have questions or need help with the DL-77 form, you can contact the Texas Department of Public Safety directly. They can provide guidance on filling out the application and clarify any specific requirements related to your situation. It is recommended to seek assistance to ensure all aspects of the application are understood and completed properly.
Using the wrong pen color: All information must be filled out in ink. Using pencil or any color other than black or blue can lead to rejection.
Incomplete personal information: Omitting critical details such as last name, first name, or date of birth can cause delays. Ensure all fields are filled accurately.
Incorrect social security number: Providing an incorrect or invalid SSN can lead to complications. Double-check the number before submission.
Not selecting the appropriate hardship reason: Clearly indicate which hardship provision applies. Failure to do so may result in a denial of the application.
Missing required signatures: Ensure all necessary signatures are included, especially from parents or guardians for minor applicants. An unsigned application will not be processed.
Neglecting to provide emergency contact information: If applicable, include emergency contacts. This information is crucial for processing your application.
Not attaching required documentation: If applying based on medical or educational reasons, ensure all supporting documents are included. Missing documents can lead to delays.
Ignoring the deadline: Remember that applications are held for only 90 days. Submit your application promptly to avoid expiration.
When applying for a Hardship Driver License in Texas using the DL-77 form, several other documents may be required or recommended to support the application process. Below is a list of commonly used forms and documents that can facilitate the application.
Gathering these documents can significantly streamline the application process for a Hardship Driver License in Texas. Ensure that all forms are completed accurately and submitted alongside the DL-77 form to avoid delays.
The Texas Form DL-77 is similar to the Texas Driver License Application (Form DL-100). Both forms serve as applications for obtaining a driver’s license in Texas. The DL-100 is a standard application for individuals seeking a regular driver’s license, while the DL-77 specifically addresses hardship licenses. Each form requires personal information, including the applicant’s name, address, and identification details. However, the DL-77 includes additional sections that focus on the specific circumstances justifying the hardship, such as economic difficulties or family emergencies, which are not present in the standard DL-100 application.
Another related document is the Texas Learner License Application (Form DL-14). This form is designed for individuals who are applying for a learner's permit, allowing them to practice driving under certain restrictions. Like the DL-77, the DL-14 requires personal information and parental consent for applicants under 18. However, the DL-14 focuses on the initial stage of obtaining driving privileges, while the DL-77 is for those needing special consideration due to hardship situations. Both forms emphasize the importance of education and safety in driving.
The Texas Identification Card Application (Form DL-56) is also comparable to the DL-77. The DL-56 is for individuals who do not wish to obtain a driver’s license but need a state-issued identification card. Similar to the DL-77, the DL-56 collects personal information and may require proof of residency. However, the DL-56 does not address hardship situations, as it serves a different purpose. Both forms aim to provide identification for Texas residents, but the DL-77 is specifically tailored for those facing unique challenges that necessitate a driver’s license.
Finally, the Texas Medical Advisory Board Form (Form DL-101) shares similarities with the DL-77. The DL-101 is used to report medical conditions that may affect a person's ability to drive safely. This form is often required alongside the DL-77 if the applicant has health concerns that could impede their driving. Both forms emphasize the importance of safety and compliance with state regulations. While the DL-77 focuses on hardship circumstances, the DL-101 addresses medical qualifications, highlighting the state's commitment to ensuring safe driving practices.
When completing the Texas Form DL-77 for a hardship driver license, there are several important considerations to keep in mind. Below is a list of dos and don'ts that can help ensure the application process goes smoothly.
When it comes to the Texas DL-77 form for a Hardship Driver License, several misconceptions can lead to confusion among applicants. Here are six common misunderstandings:
All information on the DL-77 must be filled out in ink. Using pencil will result in an invalid application.
Once the application is submitted, the Texas Department of Public Safety does not refund the payment. Applicants should be certain before submission.
Eligibility is limited to specific circumstances, such as unusual economic hardship, family illness, or enrollment in a vocational program. Not all personal situations qualify.
While it is optional, providing emergency contact details can be beneficial in case of injury or other emergencies.
Not all applicants are required to have a Learner License. The need for one depends on individual circumstances and prior licensing history.
Repeated applications can raise flags with the Department of Public Safety. If denied, it's essential to understand the reasons before reapplying.
Key Takeaways for Filling Out and Using the Texas Form DL-77