Michigan Department Of State - Record Lookup Request Page 3

Download a blank fillable Michigan Department Of State - Record Lookup Request in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Michigan Department Of State - Record Lookup Request with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

Note: An $11.00 fee is charged for each record lookup. Driver and vehicle histories can be significantly more than $11.00.

*You will be charged the $11.00 fee for each application/transaction retrieved.

Section 5. Driver/Personal ID Information (If you only need a driver record, leave Section 6a and 6b blank.)

Check boxes that apply:

☐ Driver Record

☐ Employment Only ☐ CDL Required ☐ CDL Not Required

☐ Personal ID Record

☐ Credit or Insurance

☐ Court

(Shows last reported address)

☐ Other _______________________________________________

☐ Original License Issue Date

☐ Current Application

☐ Application History*

For partial histories, please complete: from

☐ Address History*

☐ Other Driving-Related Record(s)

Date:

(Hearing, Offense License Status, etc.)

Individual’s Full Name (first, middle, last)

Date of Birth

MI Driver License/Personal ID Number

Section 6a. Vehicle Registration or Title Information

Note: Insurance information is not retained and is not available.

(If you only need a vehicle record, leave Section 5 blank; otherwise, you will be charged for the multiple records)

☐ Current Vehicle Owner and Lienholder Information

☐ Registration Information as of

☐ Copy of Current Title Application and Related Forms

☐ Complete Title History*

☐ Complete Registration History*

☐ Partial Title History*

☐ Partial Registration History*

For partial histories, please complete from:

Plate/Registration #

Vehicle Year

Make

Vehicle or Hull Identification Number

Section 6b. Any and All Vehicles/Watercraft/ORV/Snowmobile/Mobile Homes Registered/Handicap Placard or

Plate:

**When requesting records for all motor vehicles or all assets registered and/or titled through the Michigan Department of State for individuals and/or com-

panies, precise information is required. Information retrieved is based upon an exact name and address match. The individual’s name and address, as provided by

the record requestor, must match the name and address on the record(s) held by the Michigan Department of State.

Check box if you want:

☐ All motor vehicles registered or titled to this owner

☐ All other registered or titled assets for this owner

☐ Handicap Placard/Plate

Vehicle Owner’s Name

Vehicle Owner’s Address

City

State

Zip Code

BDVR-154 (12/16)