Form Mv3592 PDF Details

In the digital age, privacy has become a prime concern for individuals, especially in the wake of rampant data sharing and marketing practices. Recognizing this need for privacy protection, the Wisconsin Department of Transportation provides an option for individuals to safeguard their personal information through the MV3592 form. This form is an essential tool for residents of Wisconsin who wish to prevent their name and address from being disclosed in requests for information involving 10 or more records, which are often used for marketing purposes. By completing and submitting this form, residents can ensure that their information is withheld from such bulk requests, although it's important to note that this will not affect mailings from other data sources. The MV3592 form outlines specific conditions under which certain requesters, such as insurance companies and law enforcement agencies, may still access this personal information for legitimate purposes, including insurance underwriting, billing, vehicle safety recalls, and law enforcement activities. This form caters exclusively to individual requests, meaning if a vehicle is owned by more than one person, only the individual submitting the form will have their information withheld. The designation made through this form remains in effect indefinitely, until the requester decides to revoke it. With privacy concerns at an all-time high, understanding and utilizing forms like MV3592 is crucial for residents looking to protect their personal information from unnecessary exposure.

QuestionAnswer
Form NameForm Mv3592
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesWisconsin, Applicable, Wis, mailings

Form Preview Example

REQUEST TO WITHHOLD NAME AND ADDRESS

Wisconsin Department of Transportation

s.341.08(1m), 342.06(1)(i), 343.14(2m) Wis. Stats. MV3592 9/2012

STATEMENT OF PURPOSE/EFFECT

Under Wisconsin law, the Department of Transportation, Division of Motor Vehicles is required to provide information from its records to requesters. This information may be used for marketing purposes. If you do not want your name and address included in requests for 10 or more records, complete and return this form. This form will not eliminate mailings that originate from other sources of information used by marketers.

Certain requesters are authorized by law to receive your name and address upon request, provided such information is used for the purpose of:

•writing and renewing insurance policies and related underwriting;

•billing and paying of insurance claims;

•vehicle safety recall notification programs; and

•law enforcement activities.

A request to withhold name and address is limited to individuals. If a vehicle is jointly owned, only the owner making the request is affected. Once a request is processed, the designation will remain in effect until the person asks the department to remove it.

Mail completed form to: Wisconsin Department of Transportation

PO Box 7983

Madison, WI 53707-7983

If you have additional questions, please write to the above address or call (608) 266-1466 for vehicle registration information or (608) 266-2353fordriverlicenseinformation.

Instructions:

To request withholding of your name and address from driver license, vehicle registration, or identification cards for the physically disabled records, please provide the following information. Use of this form is limited to one person.

Please print legibly. Provide COMPLETE information. The following information is REQUIRED.

Name (Last, First, MI) AS SHOWN ON DRIVER LICENSE OR VEHICLE RECORD

Birth Date (m/d/yyyy)

Residence Street Address, City, State and ZIP Code

Driver License Number (if applicable)

Incomplete or illegible forms

will not be processed.

X

(Signature)

Date (m/d/yyyy)

Please check ALL that apply.

I have moved. Please record my new residence address as shown above.

I do not want my name and address provided from the Wisconsin Department of Transportation Driver or Vehicle records. I previously requested withholding of my name and address, but want to reverse that designation.

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