In navigating the intersection between individual privacy and the need for access to personal information within motor vehicle records, the New York State Department of Motor Vehicles (DMV) introduces the MV-15GC form, a key document underpinned by the federal Driver's Privacy Protection Act (DPPA). This form stands as a general consent mechanism, allowing for the controlled release of personal information that the DPPA otherwise protects, notably excluding sensitive details like social security numbers, phone numbers, photographs, and medical or disability information. While the DVPAA limits the circumstances under which personal information may be disseminated, the MV-15GC enables individuals to authorize the release of their personal data for permissible reasons outlined by the act. This process demands that the individual—referred to as the motorist—explicitly grants permission to a requester through a process that includes filling out, notarizing, and submitting the form. It lays out detailed instructions for both the motorist, who is the subject of the information, and the record requester, emphasizing the legal liabilities and criminal penalties tied to improper access or use of another's motor vehicle record. Hence, the MV-15GC serves a critical function in balancing privacy rights with legitimate informational needs, framed by rigorous procedural steps and legal boundaries designed to protect individuals' personal data within New York State's regulatory environment.
| Question | Answer |
|---|---|
| Form Name | Form Mv 15Gc |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | general release of personal information form, information release consent form, mv 15gc, consent to release personal information |
NewYorkStateDepartmentofMotorVehicles
GENERALCONSENT FOR RELEASE OF PERSONALINFORMATION
Background
The federal Driver's Privacy ProtectionAct (DPPA) designates certain information in motor vehicle records as Personal Information. Personal information includes a motorist's photograph, social security number, date of birth, driver license number,
The DPPAalso limits the reasons (permissible uses) for which the Department of Motor Vehicles may release records containing personal information. Acopy of the DPPA, and the permissible uses in New York State, are printed on form
Some requesters may request a copy of a record only if they have permission from the person named in the record. This formprovidesevidence(signedauthorization)ofthatpermission.
Instructions for Motorists
The motorist is the person named in a motor vehicle record. The record requester is the person requesting information about the motorist. To complete this form, print your name in the blank marked Motorist. Print the record requester's name in the blank marked Record Requester. Then visit a notary public. In the presence of the notary, sign on the line markedMotorist'sSignature,thengivethisformtothenotarytonotarize.
Afteritisnotarized,givethisformtotherecordrequester.
Instructions for Record Requesters
You may request someone else’s motor vehicle record containing personal information only if you have a permissible use as definedintheDPPA.Youmayfacecriminalpenaltiesandcivilliabilitiesifyourequestarecordforwhichyoudonothavea permissible use. Having the motorist's permission is a permissible use. This form, properly completed and notarized, is evidenceofthemotorist'spermission.
Keepacopyofthisformforfiveyearsafteryoureceivetherecordyourequested.
I,______________________________________________,authorizetheNewYorkStateDepartmentofMotorVehicles
(Motorist)
todiscloseorotherwisemakeavailableto__________________________________________personalinformationabout
(Record Requester)
meobtainedbytheDepartmentinconnectionwithamotorvehiclerecord.
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Motorist’s Signature |
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STATEOF___________________________________________ |
ss: |
COUNTYOF_________________________________________
Onthis_______________dayof____________________________,____________beforemepersonallyappeared
(month)(year)
___________________________________________,tomeknownandwhobymebeingdulysworn,acknowledged
(Motorist)
to be the person described in and who executed the foregoing consent and who acknowledged to me that he/she executed thesameforthepurposethereinstated.
Notary Public
www.nysdmv.com |