The Texas DR 1 form is an application used to request a copy of an individual's driver record from the Texas Department of Public Safety. This form allows individuals to obtain various types of records, including personal information and details about driving history, accidents, and violations. Understanding how to properly complete and submit this form can facilitate access to important driving information while ensuring compliance with state privacy laws.
The Texas DR-1 form is an essential document for individuals seeking a copy of their driver record from the Texas Department of Public Safety. This form facilitates various requests, allowing users to obtain information such as their name, date of birth, license status, and details of any accidents or moving violations within specified time frames. The form includes options for both standard and certified records, with fees varying based on the type of information requested. For instance, a basic record may cost $4.00, while a certified version of a more detailed record can be as much as $10.00. Additionally, it is important to note that the form requires the requestor to provide personal information, including their Texas driver license number and contact details, ensuring the process is secure and compliant with privacy laws. If the requestor is acting on behalf of an organization, further details about the entity and the requestor's affiliation must be included. The form also emphasizes the necessity of obtaining written consent from the driver license holder when required, underscoring the importance of privacy and legal compliance in handling personal information. Overall, the Texas DR-1 form serves as a vital tool for individuals and organizations to access driver records while adhering to state and federal regulations.
DR-1 (Rev. 5/08)
TEXASDPS
APPLICATIONFORCOPYOFDRIVERRECORD
* 0 1 2 0 0 4 *
MAILTO:DriverRecordsBureau,TexasDepartmentofPublicSafety,Box149246,Austin,TX78714-9246
Make CHECK or MONEY ORDER Payable To:
TEXAS DEPARTMENTOF PUBLIC SAFETY
Any questions regarding the information on this form should be directed to
Customer Service at 512-424-2600. Allow 2-3 weeks for delivery.
CheckTypeofRecordDesired
FEE
|
1.
Name - DOB - License Status - LatestAddress.
$
4.00
2.
Name - DOB - License Status - List ofAccidents/Moving Violations in Record within Immediate Past 3Year Period.
6.00
2A. CERTIFIED version of #2. This Record is NotAcceptable for DDC Course.
$ 10.00
3.
Name - DOB - License Status - List ofALLAccidents and Violations in Record. Furnished to Licensee ONLY.
7.00
3A. Certified version of #3. Furnished to Licensee ONLY and is Acceptable for DDC Course.
Other: (OriginalApplication, DWLS, etc.)
$ |
|.00
(If Required)
MailDriverRecordTo:
(PleasePrintorType)
Requestor’s Last Name
Requestor’s First Name
| | | | |
StreetAddress
Texas Driver License Number
| - |
City
State
Zip Code
DaytimeTelephone Number (include area code)
If requesting on behalf of a business, organization, or other entity, please include the following:
Name of business, organization, entity, etc.
YourTitle orAffiliation with above
Type of business, organization, etc. (i.e., insurance provider, towing company, private investigation, firm, etc.)
InformationRequestedOn:
| M|M | / | D |D | / | Y | Y |Y |Y |
Date of Birth
Suffix (SR., JR., etc.)
Last Name
First Name
Middle Name/Maiden Name
Individual’sWrittenConsentFor ONETIME ReleasetoAboveRequestor
(Requestor, if you do not meet one of the exceptions listed on the back of this form, please be advised that without the written consent of the driver license/ID card holder, the record you receive will not include personal information.)
I,
, hereby certify that I granted access on this one occasion to my Driver License/IDCard
record, inclusive of the personal information (name, address, driver identification number, etc.) to
.
Signature of License/ID
Card Holder or
Parent/Legal Guardian
Date
StateandFederalLawRequiresRequestorstoAgreetotheFollowing:
In requesting and using this information, I acknowledge that this disclosure is subject to the federal Driver’s Privacy ProtectionAct (18 U.S.C. Section 2721etseq.)andTexasTransportationCodeChapter730. Falsestatementsorrepresentationstoobtainpersonalinformationpertainingtoanyindivid- ualfromtheDPScouldresultinthedenialtoreleaseanydriverrecordinformationtomyselfandtheentityforwhichImadetherequest. Further,Iunder- standthatifIreceivepersonalinformationasaresultofthisrequest,itmayonlybeusedforthestatedpurposeandImayonlyresellorredisclosethe information pursuant toTexasTransportation Code §730.013. Violations of that section may result in a criminal charge with the possibility of a $25,000 fine.
IcertifythatIhavereadandagreewiththeaboveconditionsandthattheinformationprovidedbymeinthisrequestistrueandcorrect. IfIamrequest- ingthisdriverrecordonbehalfofanentity,IalsocertifythatIamauthorizedbythatentitytomakethisrequestontheirbehalf. Ialsoacknowledgethat failure to abide by the provisions of this agreement and any state and federal privacy law can subject me to both criminal and civil penalties.
Signature of Requestor
If you are not requesting a copy of your own record or do not havethe written consent of
DL/ID holder, you must provide the information requested on the reverse.
TexasDepartment
ofPublicSafety
SaveTime - RequestYourDriverRecordOnline
www.texasonline.com
Important Instructions - Read Carefully
The Texas Department of Public Safety may disclose personal information toarequestorwithoutwrittenconsentoftheDL/IDholder,onproof oftheiridentityandacertificationbytherequestorthattheuseofthepersonalinformationisauthorizedunderstateandfederallawandthat the information will be used only for the purpose stated and in complete compliance with state and federal law.
You must meet one or more of the following exceptions if you do not have written consent of the DL/ID holder to be entitled to receive personal information on the above named individual. Please initial each category that applies to the requested driver record.
1.Foruseinconnectionwithanymatterof(a)motorvehicleormotorvehicleoperatorsafety;(b)motorvehicletheft;(c)motor vehicle emissions; (d) motor vehicle product alterations, recalls, or advisories; (e) performance monitoring of motor vehi- clesormotorvehicledealersbyamotorvehiclemanufacturer;or(f)removalof nonownerrecordsfromtheoriginalowner records of a motor vehicle manufacturer to carry out the purposes of theAutomobile Information DisclosureAct, theAnti Car TheftAct of 1992, the CleanAirAct, and any other statute or regulation enacted or adopted under or in relation to a law included in the above.
2.For use by a government agency in carrying out its functions or a private entity acting on behalf of a government agency in carrying out its functions.
3.Foruseinconnectionwithamatterof(a)motorvehicleormotorvehicle operatorsafety;(b)motorvehicletheft;(c)motor vehicle product alterations, recalls, or advisories; (d) performance monitoring of motor vehicles, motor vehicle parts, or motor vehicle dealers; (e) motor vehicle market research activities, including survey research; or (f) removal of nonowner records from the original owner records of motor vehicle manufacturers.
4.Foruseinthenormalcourseofbusinessbyalegitimatebusinessoranauthorizedagentofthebusiness,butonlytoveri- fytheaccuracyofpersonalinformationsubmittedbytheindividualtothebusinessortheauthorizedagentofthebusiness and to obtain correct information if the submitted information is incorrect to prevent fraud by pursuing a legal remedy against, or recovering on a debt or security interest against the individual.
5.For use in conjunction with a civil, criminal, administrative, or arbitral proceeding in any court or government agency or beforeanyselfregulatorybody,includingserviceofprocess,investigationinanticipationoflitigation,executionorenforce- ment of a judgement or order, or under an order of any court.
6.For use in research or in producing statistical reports, but only if the personal information is not published, redisclosed, or used to contact any individual.
7.For use by an insurer or insurance support organization, or by a self insured entity, or an authorized agent of the entity, in connection with claims investigation activities, antifraud activities, rating or underwriting.
8.For use in providing notice to an owner of a towed or impounded vehicle.
9.For use by a licensed private investigator agency or licensed security service for a purpose permitted as stated on this page.
10.Forusebyanemployeroranauthorizedagentorinsureroftheemployertoobtainorverifyinformationrelatingtoahold- er of a commercial driver license that is required under 49 U.S.C. Chapter 313.
11.For use in connection with the operating of a private toll transportation facility.
12.For use by a consumer-reporting agency as defined by the Fair Credit ReportingAct (15 U.S.C. §1681 et seq.) for a pur- pose permitted under theAct.
13.For any other purpose specifically authorized by law that relates to the operation of a motor vehicle or to public safety. Please state specific statutory authority
14.For use in the preventing, detecting, or protecting against identity theft or other acts of fraud. The Department prior to release of personal information may require additional information.
This form is read by machine. Please print the numbers and letters as shown below:
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|A| B| C|D|E | F|G|H|I | J|K | L |M|N|O| P|Q|R |S|T | U|V|W| X| Y|Z|
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