Following an ALR contact, the peace officer shall submit an ALR report to the department on a form approved by the department.
  (1) ALR Reports: breath, blood or urine test refusal. This section applies to offenses under Texas Penal Code, §49.04, §49.06, §49.07, §49.08, Texas Transportation Code, Chapter 522, or Texas Alcoholic Beverage Code, 106.041. An ALR report based on a breath, blood or urine test refusal shall contain the following information:
    (A) The identity of the person by full legal name, date of birth, and driver's license number, if any;
    (B) the peace officer's sworn report or probable cause affidavit (Form DIC-23 and/or Form DIC-54);
    (C) a copy of the statutory warning delivered to the person prior to requesting a specimen of breath or blood (Form DIC-24) and/or a copy of the statutory warning for commercial motor vehicle operators delivered to the person prior to requesting a specimen of breath, blood or urine (Form DIC-55);
    (D) the person's current address;
    (E) documentation of the refusal (Form DIC-24 and/or Form DIC-55), as evidenced by:
      (i) a written refusal to give a specimen, signed by the person; or
      (ii) a statement signed by the officer stating that the person refused to give a specimen and also refused to sign the statement requested by the officer under Texas Transportation Code, §724.031.
    (F) the notice of suspension and temporary driving permit (Form DIC-25) served and/or the notice of disqualification and temporary driving permit (Form DIC-57); and
    (G) any other information required by the department on its approved form.
  (2) ALR Reports: breath, blood or urine test failures. This section applies to offenses under Texas Penal Code, §49.04, §49.07, §49.08, Texas Transportation Code, Chapter 522, or Alcoholic Beverage Code, §106.041. An ALR report based on a breath, blood or urine test failure shall be sworn to by the arresting officer (or by the peace officer requesting the specimen in the case of a commercial motor vehicle operator who is not arrested) and shall contain the following information:
    (A) The identity of the person by full legal name, date of birth, and driver's license number, if any;
    (B) the peace officer's sworn report or probable cause affidavit (Form DIC-23 and/or Form DIC-54);
    (C) a copy of the statutory warning delivered to the person prior to requesting a specimen of breath or blood (Form DIC-24) and/or a copy of the statutory warning for commercial motor vehicle operators delivered to the person prior to requesting a specimen of breath, blood or urine (Form DIC-55);
    (D) the person's current address;
    (E) a copy of the analysis of the specimen, such as a photocopy of the breath test result; and
    (F) the notice of suspension and temporary driving permit (Form DIC-25) served and/or the notice of disqualification and temporary driving permit (Form DIC-57); and
    (G) a copy of the criminal complaint, if any, that has been filed with a magistrate or delivered to a local prosecuting attorney with jurisdiction over the offense; and
    (H) any other information required by the department on its approved form.
  (3) ALR Reports: offense under Alcoholic Beverage Code, §106.041, no specimen requested. An ALR report shall contain the following information:
    (A) identity of the person by full legal name, date of birth, and driver's license number, if any;
    (B) the peace officer's sworn report or probable cause affidavit (Form DIC-23);
    (C) the person's current address;
    (D) the notice of suspension and temporary driving permit (Form DIC-25) served;
    (E) a copy of the criminal complaint, if any, that has been filed with a magistrate or delivered to a local prosecuting attorney with jurisdiction over the offense; and
    (F) any other information required by the department on its approved form.
  (4) Nothing in this section is intended to imply that any specific documents are necessary to be in evidence in a contested hearing for the department to meet its burden. This section applies only to automatic suspensions.

Source Note: The provisions of this §17.4 adopted to be effective August 19, 1999, 24 TexReg 6310; amended to be effective June 12, 2002, 27 TexReg 4990; amended to be effective March 11, 2008, 33 TexReg 2042