Form Mv-Foil - Freedom Of Information Law Request Form Page 3

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List of Permissible Uses

Driver Privacy Protection Act

Step 1) Check the permissible use(s) for the records that you want:

The Federal Driver’s Privacy Protection Act (DPPA) (18 U.S.C. §2721.et seq.) regulates access to DMV records and how the recipients of

motorists’ records subsequently share them. Pursuant to the DPPA, you must have a DPPA Permissible Use to search DMV records. A list of

permissible uses appears below:

(Recipient must check all that apply.)

1. ____ For use by any government agency, including any court or law enforcement agency, in carrying out its functions, or any private person

or entity acting on behalf of a Federal, State, or local agency in carrying out its functions.

2. ____ For use in c onnection with 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.

3. ____ For 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 personal information submitted by the individual to the business or its agents, employees, or

contractors; and

(B) if such information as so submitted is not correct or is no longer correct, to obtain the correct information, but only for the purposes

of preventing fraud by, pursuing legal remedies against, or recovering on a debt or security interest against, the individual.

4. ____ For use in connection with any civil, criminal, administrative, or arbitral proceeding in any Federal, State, or loca l 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.

5. ____ For use in research activities and for use in producing statistical reports, so long as the personal information is not published, re-

disclosed, or used to contact individuals.

6. ____ For 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, anti-fraud activities, rating or underwriting.

7. ____ For use in providing notice to the owners of towed or impounded vehicles.

8. ____ For use by any licensed private investigative agency or licensed security service for any purpose permitted under this subsection.

9. ____ For use by an employer or its agent or insurer to obtain or verify information relating to a holder of a commercial dr iver’s license that

is required under Chapter 313 of title 49 [49 U.S.C. §31301 et seq.].

10. ____ For use in connection with the operation of private toll transportation facilities.

11. ____ For any other use in response to requests for individual motor vehicle records if the State has obtained the express consent of the

person to whom such personal information pertains.

12. ____ For bulk distribution for surveys, marketing or solicitations if the State has obtained the express consent of the person to whom such

personal information pertains.

13. ____ For use by any requester, if the requester demonstrates it has obtained the written consent of the individual to whom the information pertains.

14. ____ For any other use specifically authorized under the law of the State that holds the record, if such use is related to the operation of a

motor vehicle or public safety.

To knowingly make a false statement or conceal a material fact in this written statement is a criminal offense, punishable under Penal Law

Section 210.45. In addition, anyone who makes false representation to obtain any personal information from an individual’s Motor Vehicles

record is subject to federal criminal fines under the Driver’s Privacy Protection Act (DPPA).

Step 2) Attach a copy of

driver license or government-issued identification card. (You may cover the picture.)

your

Step 3) Sign the following Privacy Certification:

I certify that I have read the Driver’s Privacy Protection Act (18 U.S.C. Sec. 2721 et seq.) and will comply fully with the terms of such

law. I also certify that I shall not request or use any information provided by the Department of Motor Vehicles that is not specifically

authorized by the Driver’s Privacy Protection Act.