Dl 015 Form PDF Details

The Department of Labor (DOL) provides forms to help employers with their compliance obligations. The DOL 015 form is one such form, used to certify that an employee has received the required wage and hour information. Employers must complete and sign this form to certify that they have provided their employees with all the necessary wage and hour information. The DOL 015 form is not difficult to complete, but it is important to understand its contents and requirements in order to avoid any compliance issues. In this blog post, we will provide a detailed overview of the DOL 015 form and its use in Wage & Hour law compliance.

QuestionAnswer
Form NameDl 015 Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesnon certified records, mva form request, mva driver eye examination forms, mva form driver records

Form Preview Example

DL-015 (07-19)

6601 Ritchie Highway, N.E. Glen Burnie, Maryland 21062

Certified/Non-Certified Driver Records Request Procedure

When requesting driving records the following procedures must be followed for 5 or more requests:

1.Three copies must be submitted when listing more than 5 requests.

2.Use only 8 1/2” x 11” white paper, no speed letters, etc.

3.Double space license numbers or names and date of birth.

4.Number 1 thru 15 requests only per page.

5.Only Maryland driver license numbers are to be listed. Do not list anything else in the license number column. The Maryland driver license number consists of an initial letter followed by twelve numbers.

They should be listed as follows:

A-000-000-000-000

6.List should be typewritten, but we will accept legible handwriting.

7.Make sure your return address is on all copies of the list, including your zip code.

8.Address requests to:

Motor Vehicle Administration Division of Driver Services Driver Records Units, Room 145 6601 Ritchie Highway, N.E. Glen Burnie, Maryland 21062

9.On the reverse of this page is a sample blank form which you may copy and use for requesting certified copies.

We are unable to process requests when the request form fails to comply with the above instructions.

If the Maryland driver license number is provided, it will not be necessary to list the individual’s name or date of birth. If the license number is not provided, the full name, including first, middle and last name, along with complete date of birth,

must be listed.

The complete name is necessary in order to convert the full name and date of birth into the soundex/driver license num- ber, to request a record.

A prepaid fee of $9.00 for each non-certified record or $12.00 for each certified record requested must accompany the request. Remittance must be in the form of a check or money order since cash could be lost in handling and stamps are not acceptable. Make check or money order payable to Motor Vehicle Administration (MVA). Checks must have

imprinted name and address and include a driver license number, and home or work telephone number. If the payor is a company, the Federal Employer’s Identification (FEIN) Number and home or work phone number must be included.

The driver license number or full name and date of birth is what will be submitted to data processing. If an incorrect number, even a single digit is incorrect on your request form, you will receive either the record of another person or no driving record under the number or name furnished, and in addition, you will be charged a fee of $9.00 or $12.00 since we must account for a fee for each record processed.

If you have any questions regarding this procedure, please do not hesitate to contact the Driver Records Unit at (410) 787-7758.

For more information, please call: 410-768-7000 (to speak with a customer agent).

TTY for the hearing impaired: 1-800-492-4575. Visit our website at: www.MVA.Maryland.gov

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Enclosed is a check in the amount of $

 

 

for

 

certified/non-certified copies of

 

 

 

Maryland driving records on the following:

Check #: ______________________

License NumberLast Name First MiddleDOBNotations

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Reason for request:___________________________________________________________________

Signature of requestor: ________________________________________________________________

Printed Name: _______________________________________________________________________

My signature acknowledges, under penalty of criminal prosecution, that I will use information received from the

Motor Vehicle Administration (MVA) solely for the purpose I describe on this application and further agree that I will not release personal information obtained from MVA records except as permitted by the Maryland Public Information Act, Title 4 of the General Provisions Article, Maryland Annotated Code, with particular attention to § 4-320.

qEmployer

Name: ___________________________________________________________________________

“I certify that I am an employer or potential employer of the individual for whom I am requesting/receiving a driving record, and that a valid commercial driver’s license is required of the individual as a condition of employment.”

q3 Year Driving Record with CDL Medical Certification ONLY.

q3 Year Driving Record non-commercial.

Employer’s Signature: ______________________________________________________________

Apply to... Apply to register to vote with your driver’s license transaction. For details ask your customer service representative.

to Vote Now!

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Filling in section 1 in mva form request

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Simple tips to complete mva form request step 2

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