DPS COPY TEXAS DRIVER EDUCATION CERTIFICATE CONTROL NO.

(Type or print legibly in black ink) DEE 00185872

FOR LEARNER LICENSE ONLY
 Driver Education School  TDLR Parent Taught Course  Duplicate (Original Control # )
 Transfer (See Back for Details)
 32 hours classroom instruction concurrent with laboratory  32 hours block classroom instruction
 Must take Class C-Road Rules, Class C-Road Signs and vision examinations with the Department of Public Safety
 Has passed Class C-Road Rules and Class C-Road Signs examinations Grade: Road Rules Road Signs and
Must take vision exam with the Department of Public Safety
 Has passed Class C-Road Rules and Class C-Road Signs examinations Grade: Road Rules Road Signs and
Has taken vision exam: Vision uncorrected: 20/ R 20/ L 20/ B Vision corrected: 20/ R 20/ L 20/ B

Under the concurrent schedule provision, if a student does not subsequently complete the required class instruction, the instructor must complete Form DL-42 and send it
to Enforcement and Compliance Service of the Texas Department of Public Safety. The Department may then revoke the student's learner license.

Name: Yang , Yuhui

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Date of Birth: 01 / 25 /2006 X Male  Female
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Last First MI
I hereby certify that the person indicated has completed and passed at least six (6) hours of driver education driving laws and procedures
and is enrolled in a driver education course approved by the Texas Department of Licensing and Regulation.

Signature of Licensed Driver Education or TDLR PT Instructor TDLR Number or TDLR PT Instructor DL Number Name of School or TDLR PT Course
05 17 2021
Signature (or Signature Stamp) of Chief School Official or TDLR PT CP Driver Education School # or TDLR PT Course # Date Issued

WARNING: You may commit a crime if you give this driver education certificate to the Department of Public Safety or to an insurance company and you did not
complete the course of hours as indicated. You may also commit a crime if you put any information on this certificate that is not true.

UNLAWFUL IF REPRODUCED OR ALTERED – INVALID IF STATE SEAL IS NOT VISIBLE

DE-964 (Rev. 9/1/15)
TRANSFER: Fill out the applicable items on the front of this certificate before proceeding. Indicate the number of hours successfully completed in the spaces
below. If the number of hours is nine or less, place a zero in front of the single digit number. (For example, if four hours were completed, enter as 04.)

CLASSROOM BEHIND-THE-WHEEL INSTRUCTION IN-CAR OBSERVATION SIMULATOR MULTI-CAR

Mail all transfer documentation to the school or parent/legal guardian indicated. Include copies of the student's instruction records verifying the
number of hours completed.

TRANSFERRING TO: Jieyi Su 3527 El Dorado BlvdHouston, TX 77459

Name of School or Parent/Guardian Address

If you have reason to believe that the minimum requirements are not being met at this driving school, please contact Texas Department of Licensing and
Regulation, PO Box 12157, Austin, TX 78711; or call (512) 463-6599 or (800) 803-9202. (All complaints must be in writing. You may request anonymity.)
AFFIDAVIT: This portion of the Texas Driver Education Certificate is to be used only when it is impossible for the student to obtain the signature of the certified
instructor of the driver education course because of the instructor leaving the school or death or serious illness. Fill out the front of this certificate showing work
completed and the name(s) of the instructor(s).

This is to certify that the signature and license number of the instructor who would have verified completion of the driver education course or the hours described

hereon could not be obtained because .

(Give specific reason why it is impossible for the actual instructor to sign.)

I therefore affirm that the instruction described has been lawfully and satisfactorily completed as shown.

Signature of Chief School Official or TDLR PT Course Provider (required) Driver Education School # or TDLR PT Course # Date Issued

Sworn to and subscribed before me this day of ,

SEAL
Notary Public: