735-7266 (7-20)
ORDER YOUR OWN RECORD
This form can be used to order your own record, by mail, from the DMV Headquarters. You can also
order your own driving records online by visiting DMV's website at www.oregondmv.com. Records
ordered using this form are mailed to you at your address shown on your DMV computer record unless
you indicate otherwise. If you want records faxed or mailed to an address other than your address on the
DMV's record, you must include enough information in your request for DMV to verify your identity, such
as: date of birth, place of birth, address of record, mother's maiden name, etc. If you are requesting a
record that contains another person's personal information as well as your own (such as a title
history or odometer history), your personal information will appear on the record(s) but other
person's will not. Please note that DMV will not certify documents that have been redacted.
INSTRUCTIONS: Fill out the name and address fields completely. You must include enough vehicle
and/or driver information for DMV to locate the record.
MAIL REQUEST TO: DMV RECORDS SERVICES, 1905 Lana Ave NE, Salem OR 97314
Please call Records Services at 503-945-5475 with questions regarding this form.
A CHECK OR MONEY ORDER, PAYABLE TO "OREGON DMV"
For a complete list of fees and records (refer to Form 735-6691) www.oregondmv.com
SPECIAL INSTRUCTIONS:
NAME OF INDIVIDUAL
TELEPHONE NUMBER (INCLUDE EXT. IF ANY)
( )
ADDRESS
ADDRESS TO MAIL TO (IF DIFFERENT)
STATE ZIP CODE
ZIP CODE
CITY
CITY
ODL / ID / CUSTOMER #
DATE OF BIRTH (MM / DD / YYYY)
MOTHER'S MAIDEN NAME
PLACE OF BIRTH (i.e. CITY, STATE)
PLATE NUMBER
VIN (VEHICLE IDENTIFICATION NUMBER)
FAX NUMBER (IF YOU WANT YOUR RECORDS RETURNED TO YOU BY FAX)
( )
TYPE OF RECORD REQUESTED
NON-EMPLOYMENT DRIVING RECORD = 3 YEAR RECORD
$1.50
DR
EMPLOYMENT DRIVING RECORD = 3 YEAR RECORD
$2.00
DE
DRIVER LICENSE INFORMATION
$1.50
DI
OPEN-ENDED NON-EMPLOYMENT DRIVING RECORD
$1.50
DO
CERTIFIED COURT PRINT = THIS OPTION MAY INCLUDE
CP
MORE THAN FIVE YEARS OF RECORD INFORMATION
$3.00
VEHICLE RECORD PRINT
$4.00
VR
VEHICLE TITLE HISTORY
$22.50
VH
PREVIOUS OWNER INFORMATION
$14.00
VO
INSURANCE INFORMATION SEARCH
$10.00
II
CERTIFICATION
$1.00
CC
OTHER:_______________________
STATE
DATE
X
SIGNATURE
CERTIFIED COURT PRINT with CDL MEDICAL CERTIFICATION
INFORMATION = MAY INCLUDE MORE THAN FIVE YEARS OF
RECORD INFORMATION
$3.00
MQ
