Form Ndr-1 - Individual'S Request For National Driver Register File Search printable pdf download

New York State Department of Motor Vehicles

INDIVIDUAL’S REQUEST FOR

NATIONAL DRIVER REGISTER FILE SEARCH

The National Driver Register (NDR) is a database of information about drivers whose driver licenses have been suspended, revoked, denied or

withdrawn, or who have been convicted of certain serious traffic violations. Any person may ask if there is information about him/her on the

NDR files, whether this information has been disclosed to anyone, and to whom it was disclosed. You will not be listed in the NDR if you have

not had a driver license cancelled, denied, revoked or suspended, or have not been convicted of a serious traffic violation.

NDR search results will be mailed directly to you at the address provided on this form. The NDR will not process your request: if the

information provided on this form is incomplete or cannot be read; or if the form is not signed in the presence of a Motor Vehicles

representative or is not notarized.

The NDR will respond to every processed request, including those where no record is found on file. If a record is found, the full record will be

copied and sent directly to you, including any older records that may have contained a reason for the license cancellation, denial, revocation or

suspension. Also, if the NDR information has been released to anyone, the report will identify who received it. The name and address of the

licensing authority in each state that reported the information will be provided in the report in case you want to ask for more detailed

information about the action reported, or if you need to correct an error. Obtaining specific information about your record, or correcting errors,

can only be done by contacting the state(s) that provided the information to the NDR. You can contact the NDR office Monday through Friday

by calling their toll free number 1-888-851-0436.

INSTRUCTIONS:

Type or clearly print all information requested.

The person whose record is being checked must authorize the NDR search by signing this form in the presence of a Motor Vehicles

representative, and must present proof of identity (see form ID-44 for acceptable proofs of identity). You may pre-sign the form,

providing your signature is notarized.

You may send this form directly to the NDR at the following address:

National Driver Register

1200 New Jersey Ave. S.E.

Washington DC 20590

you may ask a Motor Vehicles office to send your request to the NDR for you. A $10 fee is charged to do this payable by cash, or by check

or money order made payable to the Commissioner of Motor Vehicles.

Last Name

First

M.I.

Previous Last Name or Maiden Name

Date of Birth (Mo./Day/Year)

Sex

Height

Eye Color

Address Where You Get Your Mail (Include Street Number and Name, Rural Delivery and/or Box Number)

Apt. No.

City or Town

State

Zip Code

Driver License Number

State Where License was Issued Social Security Number (Optional)

SIGN HERE

__________________________________________________________________ Date ____________________________

(Sign Name in Full)

—

FOR OFFICE USE ONLY - NOT TO BE COMPLETED BY CUSTOMER

NOTARIZATION

Required only if this form is not

signed in the presence of a Motor Vehicles representative.

Proof Submitted

Birth Certificate

Driver License/ID

Credit Card

Passport

Learner Permit

INS Papers

Notary Public

Other:

Sworn to and ascribed before

Seal or Stamp

______________

me this

day

Approved By

Office

________________

in the

(Print Name)

year of __________ in the city/

Date

county of__________________

SIGNATURE

State of___________________

NDR-1 (3/13)

Form Ndr-1 - Individual'S Request For National Driver Register File Search

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