Form Mv-20a - Information Required For Production Of Confidential Motor Vehicle Information/documents
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MV-20A
INFORMATION REQUIRED FOR PRODUCTION OF CONFIDENTIAL MOTOR VEHICLE
INFORMATION/DOCUMENTS
Date of Request:
_______________________________________
Person Submitting Subpoena/Request:
_______________________________________
1
The motor vehicle information/documents you have requested are protected from disclosure under federal and state law. This informa-
tion may be disclosed when it is sought for use in connection with any ‘civil, criminal, administrative, or arbitral proceeding in any
§
Federal, State, or local court or agency.’ Ref: 18 U.S.C.
2721 (b). However, in order for the Department to exercise its discretion to
2
release such information, the personal information requested must be for a ‘permitted use.’
A ‘permitted use’ implies a ‘reasonable
3
likelihood’ that the decision maker in a court proceeding would find the information useful in the course of the proceeding. Therefore,
in order to obtain the personal information requested, please provide the Department with the following information:
(i) Please explain in the ‘Response Section’ below the anticipated use of the information:
(ii) Please explain in the ‘Response Section’ below the relevance of the information:
(iii) A certificate of service or certification hereunder that the persons whose information you seek has been
notified of a subpoena or request for information/documents. If this provision does not apply to your request, please explain in the
‘Response Section’ below.
Please respond within seven (7) business days of the date of service of the subpoena or request for information in order to secure a
timely production of records.
RESPONSE:
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
The undersigned Requestor does hereby certify that the information set forth above is true and correct.
_________________________________________________
______________________________________________
(Requestor’s Signature)
(Witness’s Signature)
_________________________________________________
______________________________________________
(Requestor’s Printed Name)
(Witness’s Printed Name)
_________________________________________________
______________________________________________
(Requestor’s Printed Address)
(Witness’s Printed Address)
_________________________________________________
______________________________________________
(Requestor’s Phone # including area code)
(Witness’s Phone # including area code)
_________________________________________________
______________________________________________
(Date)
(Date)
Mailing Address:
Title Processing Research:
Georgia Department of Revenue
Phone: 1-855-406-5221
Motor Vehicle
Title Processing - Research
PO BOX 740381
Atlanta, GA 30374
1
§§
See 18 U.S.C.
2721-2725 et seq. (the ‘Driver’s Privacy Protection Act’); O.C.G.A.
§40-3-23 and 40-2-130.
§
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Pichler v. UNITE, et al., 339 F. Supp. 2d 665 (E.D. Pa. 2004).
3
Id.
Rev. 2/2013
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