I hereby request ownership/lienholder information on the following vehicle:
*VIN:______________________________________________ *License Plate:_________________________________
Year:__________________ Make:_____________________ *Registration Decal:_____________________________
*Title Number:_______________________________________ Vehicle Type: __________________________________
* At least one (1) of these items is required to access record. (I.E.: Car, Truck, Trailer, Etc.)
Reason for Information Request: ______________________________________________________________________
(See reverse side for processing information and fee schedule.)
Oklahoma Tax Commission
Motor Vehicle Division
Vehicle Information Request
(One form per each vehicle)
State of ____________________________ , County of ________________________________ §:
Subscribed and sworn to before me this _______ day of _____________________ , _________.
My commission expires ___________________, _____________ .
____________________________________________________________ , Notary Public
Signature: _____________________________________ Printed Name of Individual: __________________________________
Daytime Phone Number: _________________________ Email Address: ____________________________________________
Company, if applicable: ____________________________________________________________________________________
City: ____________________________________ State: _______ ZIP Code: _______________
Federal and State law provide that a person making a false statement for the purpose of obtaining vehicle ownership information, or using the in-
formation for any purpose other than that use permitted by law, is unlawful and subject to criminal nes and or imprisonment. In addition, federal
law provides for possible civil action, where remedies may include actual and punitive damages plus reasonable court costs.
I understand the information being provided is condential under Federal and State law and is being released to me only for the reason I have
indicated below and is to be released to no other entity.
TO GUARANTEE RETURN OF YOUR REQUEST, THIS SECTION MUST BE COMPLETED. A NOTARY SEAL IS REQUIRED.
I am the current owner. (If not the record owner, attach proof of purchase.)
I am requesting the information on behalf of the current owner. (Written authorization from record owner is required.)
I represent a licensed wrecker/towing service identied above and the information will only be used to notify owners of
towed or impounded vehicles. Department of Public Safety Wrecker/Towing service license number:______________
The information is to be used by a legitimate business identied above or its agents, employees or contractors for use in
the normal course of business only:
A. To verify the accuracy of personal information submitted by the individual to the business or its agents, employees
B. If such information as submitted is not correct, or no longer correct, to obtain the correct information for the sole purpose
of preventing fraud by pursuing legal remedies against, or recovering on a debt or security interest against, the individual.
The information is to be used in conjunction with a civil, criminal, administrative, or arbitral proceeding in a federal, state, or
local court or agency or before any self regulating body, including service of process investigation in anticipation of litigation
and the execution or enforcement of a judgement or order, or pursuant to an order of any court.
The information is to be used by an Insurer or insurance support organization identied above, or by a self insured entity or
its agents, employees, or contractors in connection with claims investigation activities, antifraud activities, rating or
I represent a licensed private investigative agency or licensed security service identied above and the information will be
utilized for one of the above listed purposes.
I represent a governmental court or law enforcement agency identied above and the information is to be utilized in carrying
out its ofcial function
Insurance Information Release:
I represent a law enforcement agency identied above and insurance information is required in the investigation of an
accident pursuant to the provisions of OS Title 47 § 10-104.
(Print name of company, wrecker/towing service, or governmental court or law enforcement agency)
YOU MUST CONFIRM YOUR ELIGIBILITY TO RECEIVE THE REQUESTED INFORMATION BY SELECTING THE APPROPRIATE
STATEMENT BELOW (CHECK ONE):
Date of Request Total Amount Remitted with Form 769
(include $1.55 Return Mail Fee)