Form Tc 96-16 - Request For Motor Vehicle Or Boat Record Which Includes Personal Information Page 2
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2KENTUCKY TRANSPORTATION CABINET
Division of Motor Vehicle Licensing
P.O. Box 2014
Frankfort, KY 40622
(502) 564-4076
GOVERNMENT SECTION
To be completed by the requesting government agency. This information is requested only for the benefit and use in carrying
out its functions of the requesting governmental agency. The government agency agrees that no additional use will be made of
the information. Check all boxes which apply.
Odometer/Mileage Discrepancy
Copy of Certificate of Origin
Signature Verifications
Copy of O/S Title
Tax Purposes
Copy of VTR/Supporting Documents
Owner Information
Copy of Current Title
Clerk Error/Correction
Certify Documents
Transfer Dates
Court Documentation
Complete History
Other (Specify) _____________________________________
________________________________________________________
_______________________________________________________
Printed name of Person Making Request
Signature
Date
_________________________________________________
Agency
_________________________________________________
Address
_________________________________________________
City
State
Zip Code
_________________________________________________
Telephone Number
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Parent category: Legal