INFORMATION MAY BE USED ONLY FOR THE FOLLOWING APPROVED DRIVER PRIVACY PROTECTION ACT (DPPA) PURPOSES. SELECT THE PURPOSE(S) FOR WHICH YOU WILL BE ORDERING MVRS:

By a business that will use the information to verify the accuracy of information submitted by individuals for the purposes of preventing fraud, pursuing legal remedies against or recovering a debt or security interest.

By an insurer or insurance support agency in connection with claims, investigations, antifraud activities, rating or underwriting.

By an employer/agent or insurer to obtain or verify information on a Commercial License Holder.

Written consent of the person whose record is being requested (Available in: AR, CA, CO, DC, FL, HI, IL, KY, MA MN, NM, NY, ND, RI, VT, VA, WY)

Under the penalty of perjury, I attest that I shall not obtain, resell, transfer, or use the information in any manner prohibited by law. I understand that motor vehicle or
driver records that are obtained, resold, or transferred for purposes prohibited by law may subject me to civil penalties under federal and state law.