Following an ALR contact, an arresting officer shall submit an ALR report to the department on a form approved by the department.

1. (1) ALR Reports: breath or blood test refusal. An ALR report based on a breath or blood test refusal shall contain the following information:

   1. (A) the identity of the arrested driver by full legal name, date of birth, and driver's license number, if any;
   2. (B) the probable cause affidavit (Form DIC-23);
   3. (C) a copy of the statutory warning delivered to the driver prior to requesting a specimen of breath or blood (Form DIC-24);
   4. (D) the driver's current address;

   5. (E) documentation of the refusal (Form DIC-24), as evidenced by:

      1. (i) a written refusal to give a specimen, signed by the driver; or
      2. (ii) a statement signed by the officer stating that the driver refused to give a specimen and also refused to sign the statement requested by the officer under Texas Civil Statutes, Article 6701l-5, §2(c) and §2(e);
   6. (F) the notice of suspension (Form DIC-25) if served; and
   7. (G) any other information required by the department on its approved form.

2. (2) ALR Reports: breath or blood test failures. An ALR report based on a breath or blood test failure shall be sworn to by the arresting officer and shall contain the following information:

   1. (A) the identity of the arrested driver by full legal name, date of birth, and driver's license number, if any;
   2. (B) the probable cause affidavit (Form DIC-23);
   3. (C) a copy of the statutory warning delivered to the driver prior to requesting a specimen of breath or blood (Form DIC-24);
   4. (D) the driver's current address;
   5. (E) a copy of the analysis of the specimen, such as a photocopy of the breath test result; and
   6. (F) the notice of suspension (Form DIC-25) is served; and
   7. (G) a copy of the criminal complaint that has been filed with a magistrate or delivered to a local prosecuting attorney with jurisdiction over the offense; and
   8. (H) any other information required by the department on its approved form.

Source Note:The provisions of this §17.4 adopted to be effective February 15, 1995, 20 TexReg 570.