DRIVERS LICENSE DIVISION
REQUEST FOR DRIVER ABSTRACT
ND DEPARTMENT OF TRANSPORTATION
North Dakota Department of Transportation
608 E BOULEVARD AVE
SFN 51386 (Rev. 02-2015)
BISMARCK ND 58505-0750
Driver
Date
License
of
Number
Birth
Subject's Name
Subject's Address
City
State
Zip Code
Name of Requestor
Company Name ( if applicable)
Mailing Address
City
State
Zip Code
Signature of Requestor
REQUESTOR'S INFORMATION
Please check one of the following:
I am requesting a copy of my own record. REASON:
I am requesting the record of another person
and their written consent is below:
I give my written consent for the above Requestor to obtain a complete copy of my driving record.
Signature
THIS RECORD IS FOR:
a prospective employer of a Commercial Driver's License holder (must have written consent).
an employer of a Commercial Driver's License holder.
an employer or prospective employer for non-commercial driving purposes.
a government agency, including any court or law enforcement agency performing its function for an approved purpose.
insurance purposes
use by a parent of a child under 18 years of age
other (please explain)
There is a $3 fee for each record required. Record requests and the fee may be mailed to address listed above. You may fax
your request along with credit card number, expiration date, and V-code to (701) 328-2435. You may also purchase and print a
limited copy of a driving record online at https://secure.apps.state.nd.us/dot/dlts/dlos/welcome.htm. All record requests are
mailed from the Driver's License Division. Please allow 5-7 business days for processing time.