STATEMENT OF ASSURANCE

I, ________________________, attest to GetDefensive.com and the Texas Education Agency, the following:

  1. I will complete and/or have completed this online defensive driving course with no help from any person, other than the staff of GetDefensive.com.
  1. I will not/have not misrepresented my identity in any way during this online defensive driving course.
Student Signature   Date
Notary Signature   Date

Notary Seal

Copy your driver´┐Żs license below

Please return this form to GetDefensive.com
Via Fax: 1-800-519-3475

Or mail to:

1620 26th StreetSuite 1000 North
Santa Monica, CA 90404