Section 1. Short Title and Purpose. - This Implementing Rules and Regulations, hereinafter called the IRR, is promulgated pursuant to Section 7 of Republic Act No. 10930, for the purpose of prescribing the necessary rules and regulations to rationalize and strengthen the policy regarding driver's license by extending the validity period of driver's licenses, and to ensure that driver's licenses are issued only to deserving applicants with sufficient driving skills and knowledge on road safety and proper road courtesy.

Section 2. Declaration of Policy. - The provisions of this IRR are in line with the declared policy of the State to establish a system that promotes the ease of access to government services and efficient transportation regulation favorable to the people.

Section 3. Definition of Terms. - For purposes of and when used in this IRR, the following terms or words and phrases shall mean or be understood as indicated hereunder unless the context of a particular section clearly indicates that a different meaning is intended:

a. Driver - every and any licensed operator of a motor vehicle.

b. Student-driver's Permit (SP) - the authority valid for a period of one (1) year embodied in a form prescribed by the Land Transportation Office (LTO) granted to a person who desires to learn to operate motor vehicle when accompanied by a duly licensed driver possessing a driver's license with the appropriate restrictions code/s for the type of motor vehicle to be operated by the student driver.

c. Driver's License - the authority in the form prescribed by LTO granted to a person to operate motor vehicle that is either nonprofessional or professional driver's license.

d. Driver's License (DL) Code - a code represented of vehicle category that a driver may operate.

e. Point System - a method of accruing demerit points over a period of time which serves as basis for the determination of conditions for driver's license renewal, prohibition from the availment of certain transactions and revocation of a driver's license. It has as its basic element a graduated scale of points giving relative values or weights to the various traffic violations depending on their gravity.

f. Demerit Point - an arithmetical value, specified by integer numbers, assigned to and accumulated by a driver-violator for every corresponding traffic violation committed as used in the Point System.

g. Traffic Violation - acts and omissions, whether intentional or unintentional, prohibited and penalized by traffic laws, rules and regulations and local ordinances which are classified as follows:

h. Suspension - the temporary withdrawal of the Land Transportation Office of a driver's license or privilege to operate a motor vehicle on public roads or highways.

i. Revocation - the termination by formal action of the Land Transportation Office of a driver's license or privilege to operate a motor vehicle on public roads or highways.

Section 4. Issuance of Driver's License. - If, after the theoretical and practical examinations as prescribed, the Land Transportation Office (LTO) Head or his/her deputies find that the applicant possesses the necessary qualifications and proficiency in the operation of motor vehicles, is able to read and write any of the official languages or major dialect and knows how to read and interpret various traffic signs, signals and road markings, a professional or nonprofessional license may be issued to such applicant upon payment of the fee prescribed in accordance with law but prior to the issuance of said license, the applicant shall present himself/herself in person and have his/her photograph taken by the LTO. All driver's licenses issued shall be signed in the presence of the PTO head or his/her deputies and shall bear, among others, the full name, date of birth, height, weight, sex, color of eyes, blood type, complete current address, biometrics, license number, and its date of issue and expiration.

Section 5. Prescribed Fees. - The LTO shall collect reasonable fees to cover the cost and expenses of regulation. However, such fees shall not cost more than the government's procurement expense.

Section 6. Validity of Driver's License. - Except for the student-driver's permits, all drivers' licenses shall be valid for five (5) years reckoned from the birthdate of the licensee, unless sooner revoked or suspended. Provided, however, That subject to Section 26 of Republic Act No. 4136, as amended by Batas Pambansa Blg. 398, any holder of a professional or nonprofessional driver's license who has not committed any violation of Republic Act No. 4136 and other traffic laws, rules and regulations shall be entitled to a renewal of such license for ten (10) years.

Section 7. Safeguards against Falsities and Forgeries. - In the issuance of licenses, the LTO shall use such process or adopt such measures as will prevent any alteration or falsification of a license or will enable the LTO to detect any unauthorized license.

Section 8. Establishment of Stricter Rules Before the Issuance of Driver's License. - Pursuant to Section 23-A of Republic Act No. 4136, as amended by Republic Act No. 10930, the Land Transportation Office shall promulgate prerequisites and guidelines to ensure that driver's licenses are issued only to deserving applicants with sufficient driving skills and knowledge on road safety and proper road courtesy.

The conduct of theoretical and practical examinations, among others, shall be designed to sufficiently measure the competency of drivers and in accordance to the type of license applied for and its corresponding restrictions. Provided, That for professional driver-applicant, the tests must be appropriate to the vehicle and type of service and applicant intends to operate.

Section 9. Creation of a Point System and LTO Point Registry. - The Land Transportation Office shall institutionalize a point system which shall be used to assess the fitness and eligibility of driver applicants for their desired license transactions. The system shall likewise be utilized as a primary tool to identify, deter, and penalize repeat offenders of traffic laws and ordinances. For this purpose, the LTO shall establish and maintain a registry where demerit points incurred by every driver shall be recorded, stored, and access for convenient monitoring.

Section 10. Recording of Demerit Points. - Subject to Section 20 hereof, demerit point/s incurred by a driver for a traffic violation are to be recorded in the LTO demerit point registry in respect of the day on which the violation was committed.

The LTO shall record against the apprehended driver the number of demerit points corresponding to the violation/s committed, if:

Demerit points shall be individually counted for every violation committed in a single apprehension.

Section 11. Violation Demerit Point Schedule¹ . - Every violation of Republic Act No. 4136, otherwise known as the Land Transportation and Traffic Code, and other traffic laws, rules and regulations including local ordinances, subject to reportorial requirements provided under Section 23 of this IRR, shall automatically be assigned a corresponding demerit point depending on the gravity of the traffic violation and habituality of its commission based on the succeeding table:
   

Categories of Violations	Demerit Point/s
a. Grave Violations	5
b. Less Grave Violations	3
c. All other violations not otherwise enumerated as grave or less grave which shall be considered as light	1

The Secretary of the DOTr shall have the authority to review the Point System and its mechanisms. Upon the recommendation of the LTO, after due hearing and publication the Secretary may adjust the demerit point attribution herein above provided as he may deem proper and necessary.

Section 12. Double Demerit Points. - Drivers of public utility vehicles (PUV) shall be meter double the number of demerit points for every traffic violations committed while operating a For Hire motor vehicle. This provision shall likewise apply to a driver of a private motor vehicle operating as a PUV but without proper authority from the Land Transportation and Franchising Regulatory Board (LTFRB).

Section 13. Accumulation Period. - The total demerit points accumulated by every driver shall be reckoned from the date of initial issuance or last renewal of his/her driver's license to the day immediately preceding the date of his/her subsequent renewal.

The LTO shall create an accessible and efficient system to allow license holders to check or verify the status of his/her license and his/her accumulated demerit points, if there is any.

Section 14. Condition Precedent to Driver's License Renewal. - Every applicant for renewal of license to operate any motor vehicle who has accrued at least five (5) demerit points during the accumulation period shall be required to complete a driver's reorientation course to be conducted by LTO or a duly accredited service provider.

Subject to the examination requirement under Section 26 of Republic Act No. 4136, a driver who shall accumulate ten (10) or more total demerit points shall, in addition to the completion of the driver's reorientation course, be required to pass the theoretical examination before he/she may be allowed to renew his/her driver's license.

Section 15. Intervention Program. - The driver, after notification from the LTO, shall be required to undergo a mandatory driver's reorientation course to be conducted by the Land Transportation Office or a duly accredited service provider for every ten (10) accumulated demerit points or whenever the same violation is committed for at least three (3) times during the validity of the driver's license. Provided, further, That in addition to the foregoing reorientation course, a public utility vehicle driver who has committed any franchise-related violation shall undergo the training seminar conducted by the PUV Driver's Academy of the LTFRB.

Failure of the driver to complete the said intervention program within thirty (30) days from the date of the last apprehension shall cause the suspension of the driver's license upon prior notice until the required attendance to the course is complied with.

Section 16. Outright Revocation. - Without prejudice to the authority of the court in appropriate cases and except as otherwise provided in Republic Act No. 4136 as amended and other laws and issuances, the driver's license of a person who has accumulated at least forty (40) demerit points, even if confiscated by, and/or in the possession of, any other law enforcement agencies, shall be revoked immediately without need for any proceeding for a period of two (2) years reckoned from the date of settlement of fines and penalties.

Upon the revocation of any driver's license, the Land Transportation Office shall serve a notice of such revocation to the subject driver at his/her address as registered in the LTO database by registered mail. If no registry service is available in the locality of either the sender or the addressee, service may be done by ordinary mail which shall likewise constitute presumptive notice to the person concerned.

Section 17. Period of Prohibition for Change Classification of Nonprofessional Driver's License to Professional Driver's License and/or Application for Additional Driver's License Code/s. - A driver who shall accumulate a particular number of demerit points from the date of issuance of his/her driver's license shall not be allowed to apply for change classification of his/her nonprofessional driver's license to professional driver's license not be allowed to apply for additional driver's license code/s to his/her driver's license, whether professional or nonprofessional, within the period provided below counted from the date of settlement of fines and penalties:
     

Demerit Points from Date of Issuance	Period of Prohibition
1 - 2	3 months
3 - 4	6 months
5 or more	1 year

Section 18. Demerit Points Accumulated During the Validity of a Student-driver's Permit. - In addition to the accessory penalties provided under existing laws and issuances, incurring at least five (5) demerit points during the validity of the student-driver's permit shall cause the confiscation and revocation after due notice thereof, and bar the student driver from applying for another student-driver's permit for one (1) year from the date of revocation. In no case shall a person whose student-driver's permit has already been revoked for the third time be allowed to apply for a student-driver's permit.

The licensed driver duly accredited by the LTO, acting as instructor to the student-driver, shall be equally responsible and liable as the latter for any violation and for any injury or damage done by motor vehicle on account or as a result of its operation by a student-driver under his direction² . Hence, such driver-instructor shall likewise be meted demerit point/s corresponding to the violation/s incurred by the student driver without prejudice to possible sanctions by the LTO against the accreditation of the driver-instructor.

Section 19. No Carry-over of Accumulated Demerit Points. - Demerit points for every driver shall revert back to zero upon the renewal of his/her driver's license. However, the history of committed traffic violations from which previous demerit points were incurred shall be archived and shall form part of the driver's permanent records with the end view of preserving and disclosing such records to public officers and private persons for a legitimate purpose.

Provided, That for contested apprehension by implementing agencies other than the LTO which remain unresolved until the expiry date of the driver's license of the contesting apprehended violator, demerit points attributable to violations still under contest shall accrue only on the subsequent accumulation period or when such contest is resolved with finality.

Section 20. Unlawful Acts and Corresponding Penalties. - Without prejudice to the penalties provided under the Revised Penal Code and other applicable laws, the penalties corresponding to the following acts shall be imposed by the appropriate agency or officer:

Section 21. Review of Penalties. - The Secretary of the DOTr, upon the recommendation of the LTO, after due hearing and publication, shall have the power to increase or adjust the fine herein imposed once every five (5) years. Provided, That in no case shall be increase be more than five percent (5%) of the fine sought to be increased.

RULE V - RESPONSIBILITIES OF IMPLEMENTING AGENCIES

Section 22. Repository of Records. - The Land Transportation Office shall serve as the central repository of all traffic violation records.

Section 23. Reportorial Requirements. - In consonance with the preceding section, the local government units (LGUs), the Metropolitan Manila Development Authority (MMDA) or other agencies lawfully issuing traffic violation receipts shall upload the apprehension report online to the LTO facility to be developed for this purpose.

In the meantime, the local government units (LGUs), the Metropolitan Manila Development Authority (MMDA) or other agencies lawfully issuing traffic violation receipts shall transmit the apprehension report in the form prescribed by LTO³ containing all the information relevant to the traffic violation within ten (10) working days from the date of apprehension to the LTO District Offices or Regional Office which has the geographical area of responsibility (GAOR).

However, traffic agents of LGUs are prescribed from confiscating driver's license carrying out their traffic law enforcement activities unless they are duly deputized by the MMDA within Metro Manila or by the LTO⁴ .

Driver's licenses of violators included in the apprehension reports submitted by LGUs and the MMDA shall be placed on alarm in the LTO Law Enforcement and Traffic Adjudication System within twenty-four (24) hours from receipt of the report. For this purpose, no demerit points shall be incurred by and recorded against the driver-violator until the submission by the LGU or MMDA of a complete updated report on apprehension cases⁵ indicating whether such apprehension was admitted, uncontested, or affirmed or dismissed on adjudication which shall be submitted not later than three (3) working days from the lapse of the prescribed contest period of the apprehending agency.

Section 24. Online Renewal Process. - In line with the implementation of a new LTO IT system, the LTO shall create an online process for the renewal of professional and nonprofessional driver's license.

Section 25. Information, Education and Communication Campaign. - The Department of Transportation (DOTr) and the LTO shall, in coordination with the Land Transportation Franchising and Regulatory Board (LTFRB) and other concerned agencies and private stakeholders, aggressively and regularly conduct a nationwide information, education and communication (IEC) campaign on road safety, including the list of measures implemented pursuant to and violations punishable under Republic Act No. 4136 and other existing traffic laws.

Section 26. Research and Development. - The LTO shall conduct continuing research and development to ensure the efficient administration of the driver's licensing system.

RULE VI - TRANSITORY AND FINAL PROVISIONS

Section 27. Transitory Provisions. - After the effectivity of this IRR, all driver's licenses with a validity of three (3) years shall be entitled to a renewal valid for five (5) years.

All holders of driver's licenses with 5-year validity shall undergo comprehensive driver's education on road safety and proper road courtesy upon the holder's first renewal of driver's license after the effectivity of this IRR.

Section 28. Separability Clause. - If any provision or part hereof is held invalid or unconstitutional, the remainder of the IRR or provisions not otherwise affected shall remain valid and subsisting.

Section 29. Repealing Clause. - All laws, rules and regulations, issuances or parts thereof inconsistent with this IRR are hereby revoked, repealed, amended or modified accordingly.

Section 30. Effectivity. - This IRR shall take effect upon its publication in the Official Gazette or in a newspaper of general circulation, and upon registration with the Office of the National Administrative Register at the University of the Philippines Law Center, U.P. Diliman, Quezon City.

(SGD.) ARTHUR P. TUGADE
Secretary
Department of Transportation

______________________

¹ Refer to Appendix 1 for the Violation Demerit Point Schedule containing the list of categorized traffic violations

² Section 30 of Republic Act No. 4136 as amended by Batas Pambansa Blg. 398

³ Refer to Appendix 2 for the pro-forma Traffic Violation Apprehension Report

⁴ Pursuant to Section 3.4 of DILG-DOTC Joint Memorandum Circular No. 01-2008 dated September 10, 2008 and in conformity with Section 29 of Republic Act No. 4136, Section 5 of Presidential Decree No. 1605, and Section 5(f) of Republic Act No. 7924.

⁵ Refer to Appendix 3 for the Updated Report on Apprehension Case/s form

______________________

APPENDIX 1

VIOLATION DEMERIT POINT SCHEDULE

A. GRAVE VIOLATIONS     (5 Demerit Points)	B. LESS GRAVE VIOLATIONS       (3 Demerit Points)	c. LIGHT VIOLATIONS       (1 Demerit Points)
* Driving a motor vehicle used in the commission of a crime upon conviction by regular court or competent jurisdiction	* 2nd offense of Sec. 3 of R.A. 10666 (Children's Safety on Motorcycles Act of 2015) for driving a two (2)-wheeled motorcycle with a child on board on public roads where:       - there is heavy volume of vehicles;       - there is a high density of fast moving vehicles; or       - where a speed limit of more than 60/kph is imposed	* 1st offense of Sec. 3 of R.A. 10666 (Children's Safety on Motorcycles Act of 2015) for driving a two (2)-wheeled motorcycle with a child on board on public roads where:       - there is heavy volume of vehicles;       - there is a high density of fast moving vehicles; or       - where a speed limit of more than 60/kph is imposed
* Commission of a crime in the course of apprehension upon conviction by a regular court of competent jurisdiction
* Colorum violation
* Driving a motor vehicle while under the influence of alcohol, dangerous drugs and/or similar substance upon final conviction by a regular court of competent jurisdiction [Sec. 12 of R.A. No. 10586 (Anti-Drunk and Drugged Driving Act of 2013)]	* 2nd offense of Sec. 4 of R.A. 10913 (Anti-Distracted Driving Act) for acts in a motor vehicle in motion, or temporarily stopped at a traffic light or any intersection, whether diplomatic, public or private:       - Using a mobile communications device to write, send, or read a text - based communication, or to make or receive calls, and other similar acts; and       - Using an electronic entertainment or computing device to play games, watch movies, surf the internet, compose messages, read e-books, perform calculation, and other similar acts	* 1st offense of Sec. 4 of R.A. 10913 (Anti-Distracted Driving Act) for acts in a motor vehicle in motion, or temporarily stopped  at a traffic light or any intersection, whether diplomatic, public or private: - Using a mobile communications device to write, send, or read a text - based communication, or to make or receive calls, and other similar acts; and - Using an electronic entertainment or computing device to play games, watch movies, surf the internet, compose messages, read e-books, perform calculation, and other similar acts
* 3rd and succeeding offenses of Sec. 3 R.A. 10666 ((Children's Safety on Motorcycles Act of 2015) for driving two (2) wheeled with a child on board on public roads where:       - there is a heavy volume of vehicles;       - there is a high density of fast moving vehicles; or       - where a speed limit of more than 60/kph is imposed
* 3rd and succeeding offenses of Sec. 4 of R.A. 10913  (Anti-Distracted Driving Act) for acts in a motor vehicle in motion, or temporarily stopped  at a traffic light or any intersection, whether diplomatic, public or private: - Using a mobile communications device to write, send, or read a text - based communication, or to make or receive calls, and other similar acts; and - Using an electronic entertainment or computing device to play games, watch movies, surf the internet, compose messages, read e-books, perform calculation, and other similar acts	* Failure to wear the prescribed seat belt device (2nd offense) in violation of R.A. 8750 (Seat Belts Used Act of 1999)     * Failure to wear the standard protective motorcycle helmet or failure to require the back rider to wear the standard protective motorcycle helmet, under R.A. 10054 (Motorcycle Helmet Act of 2009) - 2nd offense * Smoke belching [Section 46, R.A. 8749 (Philippine Clean Air Act of 1999)] - 2nd offense	* Failure to wear the prescribed seat belt device (1st offense) in violation of R.A. 8750 (Seat Belts Used Act of 1999)       * Failure to wear the standard protective motorcycle helmet or failure to require the back rider to wear the standard protective motorcycle helmet, under R.A. 10054 (Motorcycle Helmet Act of 2009) - 2nd offense * Smoke belching [Section 46, R.A. 8749 (Philippine Clean Air Act of 1999)] - 1st offense
* Failure to wear the prescribed seat belt device (3rd offense) in violation of R.A. 8750 (Seat Belts Used Act of 1999)	* Reckless driving for 2nd offense * Obstruction	* Reckless driving for 1st offense * Driving in a place not intended for traffic or into place not allowed for parking
* Failure to require his/her passenger/s to wear the prescribed seat belt device (Sec. 12, R.A. 8750)	* Parking:         a. In an intersection         b. Within 5 meters of the intersection         c. 4 meters from the driveway entrance         d. Within 4 meters from a fire hydrant         e. In front of a private driveway         f. On the roadway side of any unmoving or parked MV at the curb or edge of the highway       g. At any place where signs of prohibitions have been installed * Allowing passengers on top/cover of MV	* Failure to carry DL or OR/CR while driving MV2/ * Overtaking on "Men Working" or "Caution" signs     * Failure to yield the right of way to vehicle within such intersection or turning therein to the left across the line of travel of the first mentioned vehicle when such vehicle has given a plainly visible signal of intention to turn
*Smoke belching [Section 46, R.A. 8749 (Philippine Clean Air Act of 1999)] - 3rd offense	* Failure to dim headlights when approaching another motor vehicle	* Failure to provide canvass cover to cargoes or freight of trucks requiring the same2/
* Axle Overloading (Violation of R.A. 8794)	* Hitching or permitting a person or a bicycle, motorcycle, tricycle or skate roller to hitch to a motor vehicle increasing speed when being overtaken	* Failure to yield right of way - failure of a vehicle entering a highway from private road or driver upon a highway to yield the right of way to all vehicles approaching in such highway
* Driving an unregistered MV	* Illegal turn - failure to pass to conduct the motor vehicle to the right of the intersection of the highway when turning to the left in going from one highway to another	*Failure to give proper sign
* Driving without valid driver's license		* Illegal turn - Failure of the driver of a motor vehicle intending to run to the right at an intersection to approach such intersection in the lane for traffic nearest to be right hand side of the highway and, in turning, to keep as close as possible to the right hand curve or edge of highway
* Reckless driving for 3rd and succeeding offenses
* Submission of fake documents in relation to the application for a driver's license (New/Renewal)	* Failure to yield the right to way to a pedestrian crossing such highway within a crosswalk except at intersection where the movement of traffic is regulated by a peace officer or by traffic signal1/
* Disregarding Traffic Signs - include other traffic violations not mentioned in the other categories but fall under this violation	* Failure to stop before traversing a "through highway" or railroad crossing	* Illegal turn - Failure of the driver of a motor vehicle intending to run to the right at an intersection to approach such intersection in the lane for traffic nearest to be right hand side of the highway and, in turning, to keep as close as possible to the right hand curve or edge of highway
* Overtaking when left side is not visible or clear of incoming traffic	* Failure to yield right of way to ambulance, police or fire department vehicles1/
* Overtaking upon a curve	* Failure to yield right of way at a "through highway" or a "Stop intersection"
* Overtaking at an intersection	* Failure to stop motor and notch handbrake or motor vehicle when unattended	* Unsafe towing
* Overtaking at no overtaking zone		* Overcharging/undercharging of fare
* Failure to yield right of way to the vehicle on the right when these vehicles approach or enter an intersection at approximately the same time	* Failure to attach or improper attachment/tampering of authorized motor vehicle license plates and/or third plate sticker	*No Franchise / Certificate of Public Convenience carried inside MV
	*Loading extending beyond projected width without permit	* Fast, defective taximeter or operating without or with an old seal taximeter
* MC carrying more passengers other than the backrider or cargo other than the saddle bags and luggage carriers	* Operating a passenger bus/truck with cargo >160 kgs	* Tampered, broken, joined, reconnected, fake or altered sealing wire
* Presentation of fake/spurious CPC/OR/CR/plates/stickers and tags	* Refusal to render service to the public or convey passenger to destination	* Failure to provide fare discount to those entitled under exiting laws and pertinent MCs of LTFRB3/
* Operating the unit/s without or with defective/ improper / unauthorized accessories, devices, equipment and parts	* Trip cutting	* No sign board
	* All violations in connection with motor vehicle registration/renewal/operation
* Carrying of illegal and/or prohibited cargoes	* Similar acts punishable under local ordinances shall be considered less grave	* Pick and drop of passengers outside the terminal
* Unauthorized motor vehicle modification		* Failure to display fare matrix
* Operating a Right Hand Drive motor vehicle		* Failure to display the international Symbol of Accessibility inside the units and/or failure to designate seats specifically for the use of Persons with Disabilities or Failure or refusal to transport PWDs
* Driving against traffic
* Illegal overtaking		* Breach of franchise conditions under 2011 Revised Terms and Condition of CPC not otherwise herein provided
* Overtaking at unsafe distance
* Overtaking at any railway grade crossing
* Fraud in relation to the registration of the motor vehicle and/or its renewal		* Failure to display "No Smoking" and/or allowing personnel or passenger to smoke inside the vehicle
* Cutting an overtaken vehicle
* Failure to give way to an overtaking vehicle		*All other violations not mentioned above or in the other categories of violations
* Overtaking upon a crest or grade		* Similar acts punishable under local ordinances shall also be considered less grave
* Increasing speed when being overtaken
* Similar acts punishable under local ordinances shall also be considered as grave violations

_________________________

Date of Apprehension

Name of Agency/LGU: ___________________________________ 

TRAFFIC VIOLATION RECEIPT		NAME OF APPREHENDED DRIVER/OPERATOR	VIOLATIONS	DRIVER'S LICENSE NUMBER	MV PLATE NUMBER	REMARKS
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

 

Prepared by:	Certified Correct:
_______________________________ Name and Signature	_______________________________ Name and Signature
______________________________ Position	______________________________ Position

 

Appendix 3

__________________________________

Date

NAME OF AGENCY/LGU: _______________________________

 

TRAFFIC VIOLATION RECEIPT	APPREHENDED DRIVER/OPERATOR	DRIVER'S LICENSE NUMBER	MV PLATE NUMBER	FINAL DISPOSITION/RESOLUTION OF VIOLATION     (Indicate the specific violations			REMARKS
				ADMITTED	CONTESTED
					AFFIRMED	DISMISSED

 
   
 

Prepared by:	Certified Correct:
_______________________________ Name and Signature	_______________________________ Name and Signature
______________________________ Position	______________________________ Position