CLEAR FORM
ORDER YOUR OWN RECORD
You can order your own record, by mail, from the DMV Headquarters. Records are mailed to you at
your address shown on your DMV computer record unless you indicate otherwise. If you want records
faxed or mailed to an address other than your address on the DMV's record, you must include enough
information in your request for DMV to verify your identity, such as: date of birth, place of birth,
address of record, mother's maiden name, etc. If you are requesting a record that contains another
person's personal information as well as your own (such as a title history or odometer history), your
personal information will appear on the record(s) but other person's will not.
INSTRUCTIONS: Fill out the name and address fields completely. You must include enough vehicle
and/or driver information for DMV to locate the record.
NAME OF INDIVIDUAL
ODL / ID / CUSTOMER #
MOTHER'S MAIDEN NAME
PLACE OF BIRTH
DATE OF BIRTH (MM / DD / YYYY)
PLATE NUMBER
VIN (VEHICLE IDENTIFICATION NUMBER)
ADDRESS
CITY
STATE
ZIP CODE
ADDRESS TO MAIL TO (IF DIFFERENT)
CITY
STATE
ZIP CODE
TELEPHONE NUMBER (INCLUDE EXT. IF ANY)
FAX NUMBER
(
)
(
)
MESSAGE:
TYPE OF RECORD REQUESTED
NON-EMPLOYMENT DRIVING RECORD = 3 YEAR RECORD $1.50
VEHICLE RECORD PRINT $4.00
DR
VR
EMPLOYMENT DRIVING RECORD = 3 YEAR RECORD $2.00
VEHICLE TITLE HISTORY $22.50
DE
VH
DRIVER LICENSE INFORMATION $1.50
PREVIOUS OWNER INFORMATION
$14.00
DI
VO
OPEN-ENDED NON-EMPLOYMENT DRIVING RECORD $1.50
INSURANCE INFORMATION SEARCH $10.00
DO
II
CERTIFIED COURT PRINT = THIS OPTION MAY INCLUDE
CERTIFICATION $1.00
CP
CC
MORE THAN FIVE YEARS OF RECORD INFORMATION $3.00
CERTIFIED COURT PRINT with CDL MEDICAL CERTIFICATION
OTHER:_______________________
MQ
INFORMATION = MAY INCLUDE MORE THAN FIVE YEARS OF
RECORD INFORMATION $3.00
SIGNATURE
DATE
X
A CHECK OR MONEY ORDER, PAYABLE TO "OREGON DMV"
For a complete list of fees and records (refer to Form 735-6691)
MAIL REQUEST TO: DMV RECORDS SERVICES, 1905 Lana Ave NE, Salem OR 97314
Please call Records Services at 503-945-5475 with questions regarding this form.
735-7266 (3-16)