Form Rv-F1313801 - Vehicle Information Request Page 2
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Use in the normal course of business by a legitimate business or its agents, employees, or contractors, but only:
a. To verify the accuracy of the personal information submitted by the individual to the business or its agents, employees, or
contractors, T
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A
. § 55-25-107(b)(3)(A); or
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b. To obtain correct information if the above is not correct or no longer correct, but only for purposes of preventing fraud,
pursuing legal remedies, or recovering on a debt or security interest against the individual. T
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A
. § 55-25-
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107(b)(3)(B).
Use in connection with any civil, criminal, administrative, or arbitral proceeding in any federal, state, or local court or agency or before
any self-regulatory body, including the service of process, investigation in anticipation of litigation, and the execution or enforcement of
judgments and orders, or pursuant to an order of a federal, state, or local court. T
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A
. § 55-25-107(b)(4).
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Use in research activities, and for use in producing statistical reports, so long as the personal information is not published, redisclosed, or
used to contact individuals. T
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A
. § 55-25-107(b)(5).
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Use by any insurer or insurance support organization, or by a self-insured entity, or its agents, employees, or contractors, in connection
with claims investigation activities, antifraud activities, rating, or underwriting. T
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A
. § 55-25-107(b)(6).
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Use in providing notice to owners of towed or impounded vehicles. T
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A
. § 55-25-107(b)(7).
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Use by any licensed private investigative agency or licensed security service for any exempted use listed. T
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. § 55-25-
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107(b)(8).
Use by any employer or its agent or insurer to obtain or verify information relating to a holder of a commercial driver license that is
required under 49 U.S.C. § 31301, et seq. T
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A
. § 55-25-107(b)(9).
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Use in connection with the operation of private toll transportation facilities. T
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A
. § 55-25-107(b)(10).
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Use by any requester, if the requester provides written consent of the person to whom the personal information pertains. T
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A
.
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§§ 55-25-106, -107(b)(13).
Use as specifically authorized under the law of the State, if that use is related to the operation of a motor vehicle or public safety. T
.
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. § 55-25-107(b)(14).
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Please describe the proposed use of the information requested, including reference to the Tennessee law under which such use is
authorized.
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
SECTION D. Redisclosure
A recipient of motor vehicle records may only resell or redisclose the information disclosed by the Department for uses permitted under the
Federal Driver's Privacy Protection Act, 18 U.S.C. §§ 2721-2725 and the Tennessee Uniform Motor Veh icle Records Disclosure Act,
T
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A
. §§ 55-25-101 through -112.
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A recipient of motor vehicle records shall make and keep for five years, records identifying each person to whom the recipient redisclosed the
information and the permitted purpose for which the information was redisclosed. Such records shall be made available upon request for
inspection and copying by a representative of the Department of Revenue or Department of Safety. T
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A
. § 55-25-107(c).
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SECTION E. Certification
I (we) certify that the information and statements on this request are true and correct, comply with the provisions of the Federal Driver's
Privacy Protection Act, 18 U.S.C. §§ 2721-2725 and the Tennessee Uniform Motor Vehicle Records Disclosure Act, T
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.
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§§ 55-25-101 through -112, and understand that the willful, unauthorized disclosure of information obtained from these records for a purpose
other than stated on this request, or the sale or other distribution of the information to a person or organization not disclosed in this request may
result in penalties imposed under 18 U.S.C. § 2724. I (we) further understand that misrepresentation of my (our) identity or the making of false
statements on this application constitutes a Class C misdemeanor, punishable by a fine not to exceed $1,000.00. T
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. § 55-25-112.
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I (we) assume responsibility for all information obtained, pursuant to the Federal Driver's Privacy Protection Act, 18 U.S.C. §§ 2721-2725,
and the Tennessee Uniform Motor Vehicle Records Disclosure Act, T
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. §§ 55-25-101 through -112.
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________________________________________
_______________________________________
_____________________
Signature
Driver’s License Number
State
Date Signed
Mail to:
State of Tennessee, Department of Revenue
Vehicle Services Division
44 Vantage Way, Suite 160
Nashville, TN 37243-8050
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