STATE OF ALASKA
DIVISION OF MOTOR VEHICLES
REQUEST FOR DRIVING RECORD BY MAIL
Form 419F Rev. 3/2018 www.alaska.gov/dmv
There is a $10 fee for each type of driving record selected. PLEASE PRINT CLEARLY.
SELECT RECORD TYPE:
FULL INDIVIDUAL RECORD
Shows current driving record status, and includes all convictions, license actions, and at-fault
accidents on record; includes full medical certification details for commercial (CDL) drivers.
Shows current driving record status, and 3 or 5 year history of convictions, license actions, and at-fault accidents required for vehicle insurance
purposes; excludes any medical certification information on record. (3 or 5 year reporting requirement is based on the type of conviction or action.)
CDL EMPLOYMENT RECORD
Shows current driving record status; full medical certification information; and conviction, license action, and at-fault accident information as
required by DOT regulations for commercial (CDL) drivers. CDL drivers must select this type of record when used for CDL employment purposes.
Alaska Driver License Number
RELEASE TO ANOTHER PERSON OR COMPANY (OPTIONAL)
By initialing this box I authorize the DMV to release my driving record to the person or company listed below:
I WANT MY RECORD TO BE SENT VIA: Email Fax Mail (Select only one)
PAYMENT INFORMATION – Credit card info may be submitted via phone or postal mail only. Please DO NOT email or fax this
information. Requests will be held for 3 days. If payment information has not been received by that time the request will be discarded
Make check or money order payable to DMV or State of Alaska. DO NOT MAIL CASH.
Security Code (3 digit code on back of card)
I understand that my credit card will be charged $10 for each driving record.
Signature of credit card holder
(Valid for 90 days)
DMV USE ONLY
I have verified ID for in-person request
FEE: CA CC CK
Submit request to DMV Research:
1300 W. Benson Blvd., Suite 410
Anchorage, AK 99503
Insperity Employment Screening