In the complex web of legal documents and requests, the Dld60 form plays a crucial role for those needing access to specific driver record information, aligning with the stringent requirements of privacy protection laws. It serves as a formal request for a Motor Vehicle Report (MVR) under the guidelines of 'permissible use #13' as dictated by the Driver Privacy Protection Act (DPPA). This act carefully delineates who can obtain these records, under what circumstances, and the penalties for misuse. The form requires detailed information from the requester, including their name, company affiliation (if applicable), contact information, and a certification statement underscoring their understanding of and adherence to the DPPA's legal framework. Moreover, it mandates the explicit consent of the individual whose records are being sought, ensuring their rights are protected. A nominal fee accompanies the form submission, signaling the bureaucratic steps required to bridge personal privacy with legitimate access needs. Designed with checks and balances, the Dld60 form embodies the careful balance between individual privacy and the necessity of access under law-abiding scenarios, demonstrating the government's attempt to protect sensitive information while accommodating valid needs for data.
| Question | Answer |
|---|---|
| Form Name | Form Dld60 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | Utah, disclosing, MVR, requesters |
REQUEST FOR MVR BASED ON
PERMISSIBLE USE #13 OF THE DPPA
This form shall be used by persons making requests for a driver record (MVR - Motor Vehicle Report) under U.C.A. 53-
PERSON REQUESTING THE MVR
Please type or print all information.
Name of Requester _________________________________ Daytime telephone _________________________
Name of Company (if applicable) _______________________________ Date of request __________________
Mailing Address ________________________________________________________________________________
(Street) |
City/State |
ZIP |
CERTIFICATION STATEMENT: I certify under penalty of law that I am entitled to personal information from the requested driver record. I am aware that there are criminal and civil penalties for knowingly obtaining, disclosing, or using the personal information for a purpose not permitted under DPPA (18 U.S.C. §§
_________________________________________
(Signature of person requesting driving record)
Fee of $6.00 enclosed.
PERSON TO WHOM THE MVR PERTAINS
The requester listed above requests access to driver record(s), including personal information as defined in 18 U.S.C. §§
Name _____________________________ |
_____________________ |
___________ |
___________________ |
(Last) |
(First) |
(Middle) |
(Date of Birth) |
Driver License Number _______________ Address (if available) _______________________________________
APPROVAL OF THE PERSON TO WHOM THE MVR PERTAINS
I am the individual to whom the MVR pertains and am the subject of the record. I grant permission for the above requester to receive a copy of my Utah driver license record (MVR) from the Utah Driver License Division.
DLD USE ONLY
Date received
DLD employee
DLD60
REV.
_______________________________________
Driver’s Signature
Sworn and subscribed to before me this______of_________________20_____
In the county of __________________________State of __________________
Notary Signature _________________________________________________
Notary Public Seal or Stamp
Notary expires:___________________________________________