Individuals Request For National Driver Register File Check In
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2Individual's Request for National Driver Register (NDR) File Check
in Accordance with the Federal Privacy Act of 1974 (Public Law 93-579)
The National Driver Register (NDR) contains only a listing of names and related identification, provided by State driver
licensing officials, of those drivers whose driver licenses have been cancelled, denied, revoked, or suspended or who have
been convicted of certain serious traffic violations. The NDR does not contain a list of any other drivers. If you have not had a
driver license cancelled, denied, revoked, or suspended or have not been convicted of serious traffic violations, you would not be
listed in the NDR. Every individual is entitled, however, to request a check of the NDR records to determine whether they appear
on the NDR file. The NDR will respond to every valid NDR inquiry.
The record content for those persons who are listed in the NDR files is limited to identification of the state(s) which have taken
action to cancel, deny, revoke, or suspend or have records of conviction of serious traffic violations. Any specific information
about the driver history, or the entire driver history, may be obtained only from the state(s) where the detailed information is
recorded. The state(s) maintaining records are the (only) contacts able to correct records in error, and the NDR will correct its
pointer records when so advised by a state indicating that a report previously made to the NDR is in error.
If the NDR has a record on you, the full record will be copied and sent to you including any older records which may have
contained a reason for license cancellation, denial, revocation, or suspension. In addition, if such information has been
disclosed by the NDR, the recipient of the information will also be identified.
The name and address of the State driver licensing official will be provided for each State listed as having reported information
on you to the NDR.
Type or Print Plainly (Avoid delays. Inquiries that cannot be read will not be processed.)
Full Legal Name (First, Middle, and Last)
Other Names Used (Maiden, Prior Name, Nickname, Professional Name, Other)
Mailing Address: Number and Street with Apartment or Rural Route/Carrier & Box #
Home Telephone (Optional)
Area Code Number
(
)
City, State and Zip Code
Work Telephone (Optional)
Area Code Number
(
)
Driver License Number and State
Soc. Security Number
(Optional)
Month, Day, and Year of Birth
Sex
Color of Eyes
Height
Weight
Driver's Signature
Date
NOTARIZATION
Notary Public
Stamp or Seal
(Mandatory)
Sworn to and ascribed before me
this _______ day of ____________
19_________ in the city/county of
_______________________________
State of ________________________
Form NDR-PRV
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