Alabama Law Enforcement Agency
Request for Motor Vehicle Record
Containing Personal Information
The federal Driver's Privacy Protection Act allows individuals to request that disclosure of certain personal information contained in
driver license and vehicle records be restricted. The Alabama Law Enforcement Agency may disclose that personal information to
any person on proof of the identity of the person requesting a record and representation by the requestor that the use of the personal
information will be strictly limited to one or more of the following:
Enter your initials in the blank to the left of the appropriate category.
Daytime Telephone Number
Signature Date
For ALEA Use Only
Information Provided to Request MVR
Identity of Person Requesting Information
Name: Last First Middle
Date of Birth
Social Security NumberDriver License Number
Name: Last
First Middle
StateCity
Address
Zip Code
Whom Do You Represent?
1. For use by any government agency, including any court or law enforcement agency, in carrying out its functions, or any
private person acting on behalf of a government agency in carrying out its functions.
2. For use in connection with matters or motor vehicles 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 owners
records of motor vehicle manufacturers.
3. For use in the normal course of business by a legitimate business or its agents, employees, or contractors;
a. To verify the accuracy of personal information submitted by the individual to the business or its agents, employees,
or contractors; and
b. If the information is 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 proceeding in any court or government agency or before any self-regulatory body, including
the service of process, investigation in anticipation of litigation, and the execution or enforcement of judgements and orders,
or pursuant to any order of any court.
5. For use in research activities, and for use in producing statistical reports, so long as the personal information is not
published, redisclosed, 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 owner or lien holder of a towed or impounded vehicle.
8. For use by an licensed private investigative agency or licensed security service for any purpose permitted under this section.
9. For use by an employer or its agent or insurer to obtain or verify information relating to a holder of a commercial driver
license which is required under the Commercial Motor Vehicle Safety Act of 1986 (Title XH of Public Law 99-570).
10. For use in connection with the operation of private toll transportation facilities.
11. For any use specifically authorized by law that is related to the operation of a motor vehicle or public safety.
12. Unrestricted or specified use with written consent of the person who is the subject of the information. (Attach written
proof of consent).
In requesting and using the information, I acknowledge that this disclosure is subject to the federal Driver's Privacy Protection Act
(Public Law 103-322) and Alabama state law. This is signed and the request is made under the penalties of law.
Note: A $5.75 fee is required along with this completed and signed form (no personal checks)
