Form Mv-15 - Request For Dmv Records Page 3
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4TO PROCESS YOUR REQUEST, WE NEED TO IDENTIFY YOU, THE REQUESTER.
STEP 2
Attach a copy of your driver license, government-issued photo ID card (you may black out the picture), or have your signature in
Step 4 notarized.
Print your name and return address below, and select the payment method.
PAYMENT METHOD
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D
O NOT SEND CASH l
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DMV Dial-in account number ___________________
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Check
Money Order
Exempt
Payable to the Commissioner of Motor Vehicles
Daytime Phone Number (Optional):
PART A
CHECK THE BOX NEXT TO EACH RECORD THAT YOU ARE REQUESTING (ALL RECORDS ARE CERTIFIED ABSTRACTS OR
CERTIFIED PHOTOCOPIES)
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$10 each
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
DRIVING ABSTRACT (RECORDS FOR THE LAST 4 YEARS)
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DRIVING RECORD HISTORY (ALSO CALLED A “LIFETIME ABSTRACT”)
ONLY YOU, OR SOMEONE YOU HAVE GIVEN WRITTEN PERMISSION TO (CHECK BOX #13 ON PAGE 4 AND INCLUDE
FORM MV-15GC), MAY ORDER THIS TYPE OF DRIVING RECORD. EXAMPLES OF WHEN THIS MAY BE REQUIRED
INCLUDE: BACKGROUND CHECKS, BAR EXAM, APPLICANTS FOR A LICENSE IN U.S OR CANADA, AND AN ATTORNEY
$10 each
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
REVIEWING CLIENT’S ENTIRE RECORD.
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$10 each
VEHICLE REGISTRATION ABSTRACT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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$10 each
VEHICLE TITLE ABSTRACT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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$11 each
. . . . . . . . . . . .
DRIVER LICENSE APPLICATION PHOTOCOPY (AVAILABLE FOR THE LAST 7 YEARS FROM CURRENT DATE)
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$11 each
. . . . . . . .
VEHICLE REGISTRATION/TITLE APPLICATION PHOTOCOPY (AVAILABLE FOR THE LAST 5 YEARS FROM CURRENT DATE)
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$11 each
. . . . . . . . . . . . . . . .
CERTIFIED SUSPENSION OR REVOCATION ORDER PHOTOCOPY (WRITE ORDER # IN PART B BELOW)
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$11 each
. . . . . .
TICKET/SUMMONS PHOTOCOPY (WRITE TICKET #, DATE OF VIOLATION, AND/OR OFFENSE, IF KNOWN, IN PART B BELOW)
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$11 each
. . . . . . . . . . . . . . . . . . . .
TICKET DISPOSITION PHOTOCOPY (WRITE TICKET # OR CASE #, IF KNOWN, IN PART B BELOW)
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$ 6 each
VEHICLE AND TRAFFIC LAW BOOK (HOW MANY?_______) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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INSURANCE INFORMATION SEARCH/INSURANCE ACTIVITY EXPANSION REPORT
$10 each
REQUIRED: REGISTRANT'S NAME, DATE OF ACCIDENT, VEHICLE YEAR & MAKE, AND PLATE # . . . . . . . . . . . . . . . . . . . . . .
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FOR-HIRE CERTIFICATE OR FS INSURANCE ID CARD
REQUIRED: REGISTRANT'S NAME; VEHICLE YEAR & MAKE; PLATE#; AND DATE OF ACCIDENT ( IF APPLICABLE)
$11 each
(AVAILABLE IF ORIGINAL REGISTRATION APPLICATION WAS MADE WITHIN 5 YEARS FROM THE CURRENT DATE). . . . . .
PART B
PROVIDE AS MUCH INFORMATION AS YOU KNOW ABOUT THE RECORDS YOU ARE REQUESTING. PLEASE PRINT OR TYPE CLEARLY.
LAST NAME
FIRST
M.I.
DATE OF BIRTH
SEX
N.Y. DRIVER OR NON-DRIVER ID #
MAILING ADDRESS (INCLUDE STREET & NO.)
APT #
CITY
STATE
ZIP CODE
PLATE NUMBER
VEHICLE YEAR & MAKE
VEHICLE IDENTIFICATION NUMBER
DATE OF ACCIDENT
TICKET, CASE, OR ORDER NUMBER
DATE OF VIOLATION
OFFENSE
PAGE 3 0F 4
MV-15 (9/15)
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