Form Dl-Dppa-1 - Driver Privacy Protection Act Request Form

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NC DMV
Driver License Section
Driver Privacy Protection Act Request Form (DL-DPPA-1)
(To ensure correct processing please read and complete this form carefully)
Chapter 123, Section 2721 of the U.S. Code (Driver Privacy Protection Act) and N.C. General Statutes 20-43.1 require that
personal information in DMV records be closed to the public. This refers to:
1.
Name
2.
Address
3.
Driver License or ID number (also called customer number or control number)
4.
Phone number*
5.
Social Security Number (SSN) *
6.
Medical and Disability Information*
7.
Photos*
* Access to this information is further restricted by various state and federal laws.
General Purpose of DPPA: The Division of Motor Vehicles and any officer, employee, or contractor of the DMV shall not
knowingly disclose or otherwise make available to any person or entity personal information about any individual obtained
by the DMV in connection with a motor vehicle record.
Personal information MAY be disclosed as follows: (CIRCLE the exemption number below that qualifies you to receive
records)
1. For the applicant's own personal record.
2.
For use by any government agency in carrying out its function, or for use by any private person or entity
acting on behalf of a government agency (List agency name:
_______________________________________)
3. For use in matters of motor vehicle or driver safety and theft, motor vehicle emissions, motor vehicle product
alterations, recalls or advisories, performance monitoring of motor vehicles, motor vehicle parts and dealers,
motor vehicle market research activities, including survey research, and removal of non-owner records from the
original owner records of motor vehicle manufacturers.
4. For use in the normal course of business by a legitimate business, but only:
a. to verify accuracy of personal information
b. to obtain correct information, but only for the purposes of:
1)
preventing fraud by the individual
2)
pursuing legal remedies against the individual
3) recovering a debt or security interest against the individual
5. For use in connection with any civil, criminal, administrative or arbitration proceeding in any federal, state or local
court or agency (includes the execution or enforcement of judgments and orders or court orders).
6. For use in research activities and statistical reports, provided that personal information must not be:
a. published
b.
redisposed
c.
used to contact individuals
7. For use by insurance companies in connection with claims investigation, anti-fraud activities, rating or
underwriting.
8. For use in providing notice to owners of towed or impounded vehicles.
9. For use by private investigators or licensed security service for any of the purposes listed herein. (Please
provide NC Private Investigator License #_______________________
10. For use by employers to verify information regarding CDL.
11. For use by any requester who has obtained written consent of the individual to whom the information pertains.
Attach a copy of the written consent.
12. For use in connection with the operation of private toll transportation facilities.
DL-DPPA-1
1
Revised January 2016, previous editions are obsolete DO NOT USE

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