To request such records this form must be completed, signed and notarized or the request will be denied.
Record holder's signature: must be signed and dated in the presence of notary.
Request: records can be obtained by walk-in, mail-in, fax, or e-mail request.
Mail-in: requests that are submitted by mail-in can only be submitted with a check or money order.
Card payments: if you are paying by credit or debit card you will now be required to pay online for the record(s) requested.
Release: once the amount due is paid in full, your record(s) will be released to the e-mail address, mailing address or fax number you provided on this form.
| Question | Answer |
|---|---|
| Form Name | Form 4681 |
| Form Length | 1 page |
| Fillable? | Yes |
| Fillable fields | 46 |
| Avg. time to fill out | 8 min |
| Edition | 11-2024 |
| Where to send | Driver License Bureau, DL Record Center, P.O. Box 2167, Jefferson City, MO 65105-2167 |
| Who signs | The record holder, in the presence of a notary |
| Matches the agency's file | Yes, checked October 2, 2026 |
| Other names | Form 4681, 4681, Missouri Form 4681, DL 4681, Request From Driver License Record Holder, Missouri driver record request |
| Official source | Form 4681 (Rev 11-2024), Missouri Department of Revenue |
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