Form Do11A PDF Details

When individuals or entities need to access vehicle registration records in New Jersey, the DO-11A form serves as the requisite document to initiate the request through the New Jersey Motor Vehicle Commission. Located in Trenton, NJ, the Certified Information Unit of the Motor Vehicle Commission stipulates that each request for vehicle registration records must be uniquely submitted on the DO-11A form, allowing no room for substitutes. The form accommodates a singular record search per submission and can be reproduced through photocopying for additional requests, ensuring accessibility and user convenience. Alongside the completed application, a proper fee—payable via check or money order to the New Jersey Motor Vehicle Commission—is mandatory, emphasizing the Commission's structured approach to processing requests. Applicants are required to furnish exhaustive details, ranging from personal identification to specific vehicle information, underscoring the thorough nature of the information gathering process. With checkboxes delineating the type of information sought, including insurance details, registrant name and address, and vehicle description, the form also demands a clear explanation regarding the purpose of the request, ensuring applicants adhere to the uses permitted under the "Drivers’ Privacy Protection Act." This legislation governs the disclosure and use of personal information retrieved from vehicle records, setting forth penalties for misuse, thereby reinforcing the legal framework that safeguards individual privacy.

QuestionAnswer
Form NameForm Do11A
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesnj registration application, nj dmv registration form, nj registration form, nj dmv registration

Form Preview Example

New Jersey

Motor Vehicle Commission

Certified Information Unit P.O. Box 146

Trenton, New Jersey 08666-0146 609-292-4102

VEHICLE REGISTRATION APPLICATION REQUEST

All requests for registration records must be submitted on form DO-11A. One record search per form. This form may be photocopied for your convenience. No other form of request will be accepted. Proper fee must accompany request form. Make check or money order (DO NOT SEND CASH) payable to the New Jersey Motor Vehicle Commission.

ALL SECTIONS OF THIS APPLICATION MUST BE COMPLETED TO OBTAIN INFORMATION

(PLEASE PRINT CLEARLY)

 

Requester Name: ____________________________________________

Phone Number:________________________

Business Name (if applicable):__________________________________

Your Claim or File #: ____________________

Street Address:___________________________________________________________________________________

City:_________________________________________ State:__________ Zip Code: ___________________

REQUESTER DRIVER LICENSE NUMBER:___________________________________________________________

(PHOTOCOPY OF CURRENT DRIVER LICENSE MUST BE INCLUDED)

I am requesting information on: (CHECK ONE)

MY OWN RECORD

ANOTHER’S RECORD

License Plate Number:_______________________ Vehicle Identification Number____________________________

Name:___________________________________________ NJ Driver License#:_____________________________________

Street Address:__________________________________________________________________________________

City:____________________________ State:________________ Zip Code:_________________________________

Date of Birth:_________________________

CHECK INFORMATION YOU REQUIRE: Insurance Information

Name and Address of Registrant

License Plate Number

Registration Expiration Date Vehicle Description

DATE YOU WANT COVERED

MONTH

DAY

YEAR

This request is being made for the following reason(s): (Indicate number of appropriate use from Page 2)

Explain in detail your reason for requesting the information and how you plan to use the information. Attach any supporting documentation.

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

If involving a lawsuit, please state your relationship to the case and type of lawsuit involved:

_________________________________________________________________________________________________

FEE: $15 per record search

The disclosure and use of the personal information (1) contained in the record you have requested is governed by the "Drivers' Privacy Protection Act", N.J.S.A. 39:2-3.3 et seq. The "Drivers' Privacy Protection Act" provides that a person who knowingly obtains or discloses information from a motor vehicle record for any use not permitted by the Act is guilty of a crime of the fourth degree and can be held liable, in a civil action in the Superior Court, to the individual to whom the information pertains, including an award of actual damages, punitive damages, and reasonable attorney's fees and litigation costs.

(1) “Personal Information” means information that identifies an individual, including an individual’s photograph; social security number; driver identification number; name; address other than the five-digit zip code; telephone number; and medical or disability information, but does not include information on vehicular

accidents, driving violations, and driver’s status.

You may either print the form on both sides of a single sheet or print and attach the two separate sheets.

Both pages 1 and 2 must be completed and submitted for you request to be considered.

REQUESTER’S PRINTED NAME AND SIGNATURE ARE REQUIRED ON NEXT PAGE.

DO-11A (R 8/10)

Page 1 of 2

Requester’s Name:

PRINT NAME

USES PERMITTED AS SET FORTH IN N.J.S.A. 39:2-3.4(c)

1.For use in connection with matters of motor vehicle or driver safety and theft: motor vehicle emissions; motor vehicle product alterations, recalls, or advisories; performance monitoring of motor vehicles, motor vehicle parts and dealers; motor vehicle market research activities, including survey research; and the removal of non-owner records from the original owner records of motor vehicle manufacturers.

2.For use in the normal course of business by a legitimate business or its agents, employees or contractors, but only:

a.to verify the accuracy of personal information submitted by the individual to the business or its agents, employees, or contractors; and

b.if such information as so submitted is not correct or is no longer correct, to obtain the correct information, but only for the purposes of preventing fraud by, pursuing legal remedies against, or recovering on a debt of security interest against the individual.

3.For use in connection with any civil, criminal, administrative or arbitral proceeding in any federal, state or local court or agency or before any self-regulatory body, including service of process, investigation in anticipation of litigation, and the execution or enforcement of judgments and orders, or pursuant to an order of a federal, state or local court.

4.For use in research activities, and for use in producing statistical reports, so long as the personal information is not published, redisclosed, or used to contact individuals.

5.For use by any insurer or insurance support organization, or by a self-insured entity, or its agents, employees, or contractors, in connection with claims investigation activities, antifraud activities, rating or underwriting.

6.For use in providing notice to the owners of towed or impounded vehicles.

7.For use by an employer or its agent or insurer to obtain or verify information relating to a holder of a commercial driver's license that is required under the "Commercial Motor Vehicle Safety Act," 49 U.S.C. App. § 2710 et seq.

8.For use in connection with the operation of private toll transportation facilities.

9.For use by any requester, if the requestor demonstrates it has obtained the notarized written consent of the individual to whom the information pertains. Must attach Notarized Authorization To Release Personal Motor Vehicle Information form DO-21A.

I certify that I will use any personal information contained in the record(s) I have requested only as permitted by the “Drivers’ Privacy Protection Act”, N.J.S.A. 39:2-3.4(c). I further certify that all the foregoing statements are true to the best of my knowledge. I understand that if any of the statements are willfully false, I am subject to punishment.

Date:

(Original Signature Only - Signature Stamps Are Unacceptable)

DO-11A (R 8/10)

Page 2 of 2

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1. Fill out your nj registration application with a group of major blanks. Note all of the information you need and make sure not a single thing forgotten!

do 11a form nj writing process clarified (stage 1)

2. The next stage is usually to submit the next few blanks: Name and Address of Registrant, Vehicle Description, License Plate Number, This request is being made for the, If involving a lawsuit please, FEE per record search, The disclosure and use of the, Personal Information means, and You may either print the form on.

Stage # 2 in filling in do 11a form nj

It's easy to make a mistake while filling in the Vehicle Description, hence make sure that you take another look prior to deciding to submit it.

3. This 3rd segment is fairly uncomplicated, Requesters Name, PRINT NAME, USES PERMITTED AS SET FORTH IN, For use in connection with, For use in the normal course of, a to verify the accuracy of, employees or contractors and, b if such information as so, and For use in connection with any - all of these form fields will need to be completed here.

How to fill out do 11a form nj stage 3

4. To move ahead, this form section will require filling out a handful of blank fields. These comprise of I certify that I will use any, Date, Original Signature Only Signature, DOA R, and Page of, which you'll find key to moving forward with this particular document.

Writing section 4 of do 11a form nj

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