Form 419f - Request For Driving Record

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Instructions for AK Driving Record Release
Applicant/employee should fill out the following information ONLY:
Record type, choose one of the following:
o Full Record Non-CDL (for Non-CDL licenses)
o Record for CDL Employment / CDL Holder (for CDL licenses)
Requestor Name
Phone number
AK Driver’s License Number OR Date of Birth & SSN
Initial the box in the Release area
Signature and Date of Requestor
Do NOT fill out the credit card information OR sign the credit card authorization at
the bottom. Please leave those BLANK.
Once filled out, please fax to (800) 403-9044.


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