DPR-104 Form – The DPR-104 form, officially titled the Impaired Driver Program Service Agreement, is a critical document for organizations seeking to operate or update an Impaired Driver Program (IDP) in New York State. Issued by the New York State Department of Motor Vehicles (DMV), this form outlines the legal responsibilities of IDP providers to motorists and the DMV.
If you are a sponsor agency, municipality, facility, school, or organization applying to run IDP classes (formerly known as the Drinking Driver Program or DDP), the DPR-104 is required. Below is a complete, up-to-date guide based on the official DMV resources as of March 2026.
What Is the DPR-104 Form?
The DPR-104 is a 6-page service agreement between the New York State DMV and the Impaired Driver Program (IDP) provider. It establishes the provider’s obligations for delivering education and services to drivers convicted of alcohol- or drug-related driving offenses.
By signing the DPR-104, the IDP agrees to follow:
- Article 21 and Section 1196 of the New York State Vehicle and Traffic Law
- DMV regulations (15 NYCRR Part 134)
- The New York State Impaired Driver Program Director’s Guide (DPR-175), which is incorporated by reference
The current version is DPR-104 (1/26), revised January 2026, making it the most up-to-date form available.
Who Must Complete the DPR-104 Form?
Organizations must submit the completed and signed DPR-104 in these situations:
- When applying to establish a new IDP (with form DPR-103)
- When requesting an IDP name change
- When requesting a sponsoring agency name change
- When notifying DMV of a newly appointed IDP director
- Upon DMV request
It is not a form for individual drivers. Motorists enroll in an approved IDP separately to qualify for a conditional license after a DWI/DUI conviction.
Purpose of the Impaired Driver Program Service Agreement
The DPR-104 ensures that every IDP provider:
- Protects motorists’ rights
- Maintains high standards of instruction and oversight
- Operates in full compliance with state law and DMV rules
- Avoids conflicts of interest
It formalizes the IDP’s responsibility to deliver consistent, quality programming that helps reduce impaired driving while supporting safe re-licensing.
Key Responsibilities Outlined in DPR-104
The agreement is divided into clear sections covering responsibilities to the motorist and to the DMV.
Responsibilities to Motorists
- Adhere strictly to the curriculum and regulations (no unapproved deviations)
- Provide interpreters for deaf or hard-of-hearing participants
- Handle appeals of adverse decisions fairly per DPR-175 and DMV rules
- Not deny participation to indigent motorists certified by a court
- Avoid conflicts of interest with treatment providers
Responsibilities to the DMV
- Submit director and instructor applications (DPR-102) for approval
- Ensure all instructors complete required training and continuing education (minimum 18 hours every 3 years)
- Monitor classroom quality and class size limits
- Submit classroom site inspection reports (DPR-125) for new or changed locations
- Maintain financial viability (new applicants must include a Fiscal Feasibility Worksheet)
- Report non-compliant actions promptly
- Indemnify and hold the DMV harmless for any claims arising from program operations
DMV can suspend or revoke instructor certification for fraud, harassment, discrimination, unprofessional conduct, or criminal convictions.
How to Fill Out and Submit the DPR-104 Form?
- Download the latest PDF: https://dmv.ny.gov/forms/dpr104.pdf
- Enter the Business ID Number for Program (office use only) and the full name of the Impaired Driver Program.
- Complete all required fields for the provider.
- Have the authorized representative sign and date the agreement.
- Mail the original signed form along with:
- Completed DPR-103 (Impaired Driver Program Application)
- DPR-102 for each instructor
- All required attachments (resume for director, Fiscal Feasibility Worksheet if new, etc.)
Mailing address: Impaired Driver Program
New York State Department of Motor Vehicles
6 Empire State Plaza, Room 337
Albany, NY 12228
Do not fax or email the original service agreement.
Related Forms You’ll Need
- DPR-103: Impaired Driver Program Application (main application)
- DPR-102: Impaired Driver Program Instructor Application (one per instructor)
- DPR-125: Classroom Site Inspection Report (for new or changed locations)
- DPR-175: Director’s Guide (reference document – not submitted)
All forms are available free on the official NY DMV Forms & Publications page.
Why Compliance with DPR-104 Matters?
Signing and following the DPR-104 protects your organization’s ability to operate an IDP, ensures eligibility for motorists seeking conditional licenses, and helps maintain statewide standards that reduce impaired driving incidents. Non-compliance can result in denial of approval, suspension of instructor certifications, or revocation of the program.
Frequently Asked Questions About DPR-104
Is the DPR-104 form for drivers or providers?
It is exclusively for IDP providers and sponsor agencies.
Can I download and print the DPR-104 PDF?
Yes – the official, fillable version is always available at https://dmv.ny.gov/forms/dpr104.pdf.
How long is the agreement valid?
It remains in effect until the IDP is no longer approved or until a new agreement is required (e.g., name change or new director).
Do I need to submit it every year?
No, only in the specific situations listed above or upon DMV request.
Where can I find a list of approved IDPs?
Visit the official NY DMV Impaired Driver Programs by County page.
For the most current information, always refer directly to the New York State DMV website (dmv.ny.gov). The DPR-104 form and all related IDP documents are updated periodically to reflect changes in law and regulations.
Download the official DPR-104 Impaired Driver Program Service Agreement PDF here:
https://dmv.ny.gov/forms/dpr104.pdf
If you are preparing an IDP application or need assistance understanding the requirements, contact the DMV Impaired Driver Program unit at the address above or check the latest Director’s Guide (DPR-175) for detailed operational standards. Stay compliant and help keep New York roads safer.