NYS DMV Form DPR-104. Impaired Driver Program Service Agreement

The NYS DMV Form DPR-104 is a service agreement that all Impaired Driver Programs (IDPs) must agree to in order to operate an IDP. The purpose of this form is to define the responsibilities of the IDP towards motorists, the program itself, and the DMV. It outlines the terms and conditions that the IDP must adhere to during its operation.

This form is required to be submitted with Form DPR-103 and all original application materials when applying for the establishment of an Impaired Driver Program. Additionally, the applicant must also submit a separate DPR-102 form for each instructor involved in the program.

When filling out this form, it is crucial to carefully read and understand the terms included in the service agreement. Providing accurate and truthful information is essential to ensure compliance with the specified responsibilities outlined in the agreement.

Application Example: An organization or agency applying to establish an Impaired Driver Program in New York would complete this form as part of the application process. By reviewing and agreeing to the terms in the DPR-104 form, they demonstrate their commitment to providing responsible and effective services within the IDP framework.