STATE OF ALASKA
DIVISION OF MOTOR VEHICLES
REQUEST FOR DRIVING RECORD
There is a $10 fee for each type of driving record selected. PLEASE PRINT CLEARLY.
Submit request to DMV Research:
SELECT RECORD TYPE:
1300 W. Benson Blvd., Suite 410
Anchorage, AK 99503
FULL INDIVIDUAL RECORD
Shows current driving record status, and includes all convictions, license actions, and at-fault
accidents on record; includes full medical certification details for commercial (CDL) drivers.
Shows current driving record status, and 3 or 5 year history of convictions, license actions, and at-fault accidents required for vehicle insurance
purposes; excludes any medical certification information on record. (3 or 5 year reporting requirement is based on the type of conviction or action.)
CDL EMPLOYMENT RECORD
Shows current driving record status; full medical certification information; and conviction, license action, and at-fault accident information as
required by DOT regulations for commercial (CDL) drivers. CDL drivers must select this type of record when used for CDL employment purposes.
Alaska Driver License Number
Date of Birth
Social Security Number
RELEASE TO ANOTHER PERSON OR COMPANY (OPTIONAL)
By initialing this box I authorize the DMV to release my driving record to the person or company listed below:
Contact Phone Number
I WANT MY RECORD TO BE SENT VIA:
Mail (Select only one)
Signature of Requestor
Date (Valid for 90 days)
Make check or money order payable to DMV or State of Alaska. DO NOT MAIL CASH.
MasterCard or Visa #
Name as shown on card
Security Code (3 digit code on back of card)
I understand that my credit card will be charged $10 for each driving record.
Signature of credit card holder
(Valid for 90 days)
DMV USE ONLY
AMVC ID / OFFICE
I have verified ID for in-person request
Form 419F Rev. 1/2016