EXAMPLE 13

Request For Information From Texas Driver Licensing Records

Mail to: Texas Department of Public Safety, P. O. Box 4087, Austin, Texas 78765

TYPE OF INFORMATION DESIRED

• 1. Date of birth - License status - Latest address
• 2. Date of birth - License status - List of accidents and violations in record within immediate past 3 year period
• 3. Same as #2 (above) - Certified.
• 4. Date of birth - License status - List of all accidents and violations in record. THIS RECORD FURNISHED TO LICENSEE ONLY.
• 5. Same as #4 (above) - Certified. THIS RECORD FURNISHED TO LICENSEE ONLY.

INDIVIDUAL ABOUT WHOM INFORMATION IS REQUESTED

Texas Driver License Number :
Date of Birth (month/year/day):
Name: ( Last First Middle or Maiden)

RECORD REQUESTED BY

Name of person or firm making request :
Mailing Address :
Street/Box Number :
City, State, Zip :

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