Form MV-15D "Motor Vehicle Record Search Logon or Debit Account Application" - New York

What Is Form MV-15D?

This is a legal form that was released by the New York State Department of Motor Vehicles - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on December 1, 2019;
  • The latest edition provided by the New York State Department of Motor Vehicles;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form MV-15D by clicking the link below or browse more documents and templates provided by the New York State Department of Motor Vehicles.

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Download Form MV-15D "Motor Vehicle Record Search Logon or Debit Account Application" - New York

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MOTOR VEHICLE RECORD SEARCH LOGON
OR DEBIT ACCOUNT APPLICATION
The New York State Department of Motor Vehicles (DMV) is authorized to disclose personal information from a search
of DMV records when the personal information will be used for a “permissible use”, defined in the federal Driver's
Privacy Protection Act (“DPPA”) (18 U.S.C. §2721.et seq.) You must review, and be familiar with, the DPPA to complete
the application process and to conduct searches of DMV records. Form MV-15DPPA contains more information about the
DPPA and can be found on our website at http://dmv.ny.gov/forms/mv15dppa.pdf.
Each electronic search of DMV records costs $7. Searches conducted by a government agency are exempt from this fee.
Applicants are required to provide the information requested below and to execute the Terms of Service Agreement. Both
the completed application and the Terms of Service Agreement can be scanned/emailed to: DataServices@dmv.ny.gov,
faxed to Data Services at 518-474-0718 or mailed to:
DATA SERVICES
NYS DEPARTMENT OF MOTOR VEHICLES
6 EMPIRE STATE PLAZA
ALBANY NY 12228
Please mark one of the following boxes to indicate which service you are requesting:
o
Open new debit account or acquire a new search logon
o
Update information for an existing debit account. ACCOUNT #:_____________________________
APPLICANT INFORMATION
(Please Print or Type)
Applicant:
Applicant’s Driver License Number:
State that Issued License:
Applicant’s Business Email Address:
Business Name:
Business Address:
(DO NOT GIVE ONLY A P.O. BOX)
City:
State:
Zip Code:
Telephone:
-
-
Ext.
Agency/Business Director Name:
Agency/Business Director Title:
Agency/Business Director Email Address:
Federal Employer ID Number:
If a Motor Vehicle Debit Account was previously held by you, your organization, or any principal, agent, officer or
employee associated with your organization, please provide the account number(s):
MV-15D (12/19)
dmv.ny.gov
PAGE 1 OF 6
-
MOTOR VEHICLE RECORD SEARCH LOGON
OR DEBIT ACCOUNT APPLICATION
The New York State Department of Motor Vehicles (DMV) is authorized to disclose personal information from a search
of DMV records when the personal information will be used for a “permissible use”, defined in the federal Driver's
Privacy Protection Act (“DPPA”) (18 U.S.C. §2721.et seq.) You must review, and be familiar with, the DPPA to complete
the application process and to conduct searches of DMV records. Form MV-15DPPA contains more information about the
DPPA and can be found on our website at http://dmv.ny.gov/forms/mv15dppa.pdf.
Each electronic search of DMV records costs $7. Searches conducted by a government agency are exempt from this fee.
Applicants are required to provide the information requested below and to execute the Terms of Service Agreement. Both
the completed application and the Terms of Service Agreement can be scanned/emailed to: DataServices@dmv.ny.gov,
faxed to Data Services at 518-474-0718 or mailed to:
DATA SERVICES
NYS DEPARTMENT OF MOTOR VEHICLES
6 EMPIRE STATE PLAZA
ALBANY NY 12228
Please mark one of the following boxes to indicate which service you are requesting:
o
Open new debit account or acquire a new search logon
o
Update information for an existing debit account. ACCOUNT #:_____________________________
APPLICANT INFORMATION
(Please Print or Type)
Applicant:
Applicant’s Driver License Number:
State that Issued License:
Applicant’s Business Email Address:
Business Name:
Business Address:
(DO NOT GIVE ONLY A P.O. BOX)
City:
State:
Zip Code:
Telephone:
-
-
Ext.
Agency/Business Director Name:
Agency/Business Director Title:
Agency/Business Director Email Address:
Federal Employer ID Number:
If a Motor Vehicle Debit Account was previously held by you, your organization, or any principal, agent, officer or
employee associated with your organization, please provide the account number(s):
MV-15D (12/19)
dmv.ny.gov
PAGE 1 OF 6
Applicant:
Driver's Privacy Protection Act (DPPA)
The Federal Driver’s Privacy Protection Act (18 U.S.C. §2721.et seq.) (“DPPA”) regulates access to Motor Vehicles records. Recipient
hereby certifies that the information provided hereunder by DMV shall be used solely for the following purpose(s).
(Applicant must check all that apply.)
1.
Use in any civil, criminal, administrative, or arbitral proceeding in any court or agency, including the service of process, investigation in
anticipation of litigation, and the execution or enforcement of judgments and orders or pursuant to a court order. (18 U.S.C. §2721 (b)(4))
2.
Use by an insurer or insurance support organization or self-insured entity in claims investigations, anti-fraud activities, rating or
underwriting activities. (18 U.S.C. §2721 (b)(6))
Use in providing notice to the owners of towed or impounded vehicles. (18 U.S.C. §2721 (b)(7))
3.
4.
Use by an employer, its agent or insurer to obtain information relating to the holder of a commercial driver's license required under
Chapter 313 of Title 49 of the U.S.C. (18 U.S.C. §2721 (b)(9))
5.
For use in the normal course of business by a legitimate business or its agents, employees, or contractors, but only-
(A) to verify the accuracy of personal information submitted by the individual to the business or its agents, employees, or
contractors; (18 U.S.C. §2721 (b)(3)(A)) and
(B) if such information as so submitted is not correct or is no longer correct, to obtain the correct information, but only for the
purposes of preventing fraud by, pursuing legal remedies against, or recovering on a debt or security interest against, the
individual. (18 U.S.C. §2721 (b)(3)(B))
6.
Use required under NYS Vehicle and Traffic Law, Article 19A - Special Requirements for Bus Drivers. (18 U.S.C. §2721 (b)(14))
7.
Use required under NYS Vehicle and Traffic Law, Article 19B - Special Requirements for Commercial Motor Carriers.
(18 U.S.C. §2721 (b)(14))
Use by any government agency, including any court or law enforcement agency, in carrying out its functions. (18 U.S.C. §2721
8.
(b)(1))
9.
Use by any private person or entity acting on behalf of a federal, state, or local agency in carrying out its functions.
(18 U.S.C. §2721 (b)(1))
10.
Use in matters of motor vehicle or driver safety. (18 U.S.C. §2721 (b)(2))
11.
Use in matters of motor vehicle theft. (18 U.S.C. §2721 (b)(2))
12.
Use in matters of motor vehicle emissions. (18 U.S.C. §2721 (b)(2))
13.
Use in matters of motor vehicle product alterations, recalls or advisories. (18 U.S.C. §2721 (b)(2))
14.
Use in performance monitoring of motor vehicles, motor vehicle parts and dealers. (18 U.S.C. §2721 (b)(2))
15.
Use in motor vehicle market research activities, including survey research. (18 U.S.C. §2721 (b)(2))
16.
Use in removal of non-owner records from the original owner records of motor vehicle manufacturers. (18 U.S.C. §2721 (b)(2))
17.
Use in the operation of private toll transportation facilities. (18 U.S.C. §2721 (b)(10))
18.
For use by any requester, if the requester demonstrates it has obtained the written consent of the individual to whom the information
pertains. (May use form MV-15GC). (18 U.S.C. §2721 (b)(13))
19.
Use specifically authorized under NYS law, IF such use is related to the operation of a motor vehicle or public safety.
Cite the specific NYS law here:
(18 U.S.C. §2721 (b)(14))
20.
Use in research activities and in producing statistical reports,
as long as the personal information is not published, disclosed or
used to contact individuals.
(18 U.S.C. §2721 (b)(5))
Making a false representation to obtain any personal information from DMV records
subjects you to federal criminal fines under the DPPA.
MV-15D (12/19)
PAGE 2 OF 6
reset/clear
Applicant:
Commercial and Not-For-Profit Applicants
Individuals employed by, or working on behalf of, a commercial entity or not-for-profit organization:
Must pay a $7 per search fee.
Must establish a debit account funded by an opening deposit of not less than $100. Make your check or money
order payable to “Commissioner of Motor Vehicles” and attach it to this application.
Must execute the Terms of Service Agreement and return it to DMV along with this application.
x
Signature of Applicant:
Date:
Government Applicants
Individuals employed by, or working on behalf of, a government organization; volunteer fire company; volunteer
ambulance service; or legal aid bureau or society or other private entity when acting pursuant to Section 722 of the New
York State County Law, are “government” applicants. Government applicants:
Are exempt from paying the $7 per search fee.
Must complete the Fee Exemption Certification (below) to claim the exemption from search fees under
Section 202 of the New York State Vehicle and Traffic Law.
Must provide evidence of your government employment or your affiliation with the exempt organization, such
as a pay stub or an official letter from the organization.
Must execute the Terms of Service Agreement and return it to DMV along with this application.
FEE EXEMPTION CERTIFICATION FOR GOVERNMENT ORGANIZATIONS, VOLUNTEER FIRE COMPANIES,
VOLUNTEER AMBULANCE SERVICES, AND ENTITIES ACTING PURSUANT TO SECTION 722 OF THE NEW
YORK STATE COUNTY LAW
Section 202 of the New York State Vehicle and Traffic Law exempts government organizations, volunteer fire
companies, and volunteer ambulance services from fees for searches to be used for a public purpose, and also
exempts legal aid bureaus and societies and other private entities from such fees when acting pursuant to Section
722 of the New York State County Law. I certify that my organization qualifies for this exemption, and that I will
use my search logon only for qualified fee-exempt purposes.
FOR NY STATE & COUNTY BOARD OF ELECTION OFFICES ONLY:
Indicate below what records you are requesting access to (select only one box).
o
o
o
Motor Vehicle Records
Motor Voter Database
BOTH Motor Vehicle Records & Motor Voter Database
x
Signature of Applicant:
Date:
I understand that making a false statement, or submitting any
documentation that is false, may be punishable as a criminal offense.
MV-15D (12/19)
PAGE 3 OF 6
reset/clear
Applicant:
MOTOR VEHICLE RECORD SEARCH LOGON
TERMS OF SERVICE AGREEMENT
The federal Driver's Privacy Protection Act (DPPA) (http://dmv.ny.gov/forms/mv15dppa.pdf) prohibits the New York State
Department of Motor Vehicles (DMV) from disclosing or otherwise making available to any person or entity any “personal
information” as defined within DPPA unless the authorized user possesses a “permissible use” for the personal information.
Authorized Users of a Motor Vehicle Record Search Logon are subject to the terms and conditions outlined below:
1. The Applicant agrees to review, and be familiar with, the DPPA.
2. The Applicant must possess the “permissible use” selected on the application for each search of DMV records
using the Motor Vehicle Record Search Logon to obtain personal information.
3. The Applicant understands that knowingly making a false representation to obtain any personal information from
DMV records is subject to criminal fines and that knowingly obtaining, disclosing or using personal information,
from a DMV record, for a purpose not permitted under the DPPA shall be liable to the individual to whom the
information pertains, who may bring a civil action in a United States district court.
4. The Applicant agrees to only obtain personal information from DMV records when, for each search, the Authorized
User possesses a DPPA “permissible use”.
5. The Applicant agrees to use the Motor Vehicle Record Search Logon in full compliance with the DPPA.
6. The Applicant will be responsible for ensuring that:
the Motor Vehicle Record Search Logon is used only for searches permitted by the DPPA and as authorized
by this Agreement;
DMV has accurate and up-to-date contact information;
DMV has accurate and up-to-date employment information for the Applicant, including contact
information for the Applicant’s agency/business Director; and,
The Applicant must notify DMV, within 30 days, of any change in contact/employment information.
7. The Applicant’s organization must maintain business records that establish a permissible use for each search.
The business records must be maintained for five years after the date of the search;
The business records must be made available to DMV upon receipt of a Verification Request letter; and
At DMV’s direction, the business records must be forwarded to DMV or made available for inspection by
DMV within 30 days of any request.
8. The Applicant understands that a business record is a document that records an event, business dealing or
transaction associated to each use of the Motor Vehicle Record Search. The business record you provide
must pre-date receipt of a Verification Request letter, and it should identify the SEARCH CRITERIA used in your
search. DMV recommends a log be maintained of each search performed with a notation of what was searched
(i.e. plate number, DMV client ID number, vehicle identification number) the date of the search, and your business
identifier (i.e. index number, case number, client number, etc.) that can direct you to the associated business record.
Common examples of business records include:
Court Orders
Lien and Judgment Filings
Crash/Incident Reports
Emergency or Help Calls
Case Files
Traffic/Criminal/Civil
Summonses
Invoices /Receipts
Payroll Advices
Service Applications
Employment Applications
MV-15D (12/19)
PAGE 4 OF 6
Applicant:
MOTOR VEHICLE RECORD SEARCH LOGON TERMS OF SERVICE AGREEMENT (continued)
9. The Applicant understands that failure to provide a business record establishing a permissible use for any search,
may result in the imposition of sanctions by DMV, including a suspension of access rights, or termination of the
Motor Vehicle Record Search Logon.
10. The Applicant acknowledges that DMV has the right to demand production of a business record establishing the
permissible use underlying each search of DMV records and to perform all necessary audit steps to ensure the
Motor Vehicle Record Search Logon is used only as authorized by this agreement.
11. The Applicant understands that termination of their Motor Vehicle Record Search Logon for inappropriate use may
prohibit reinstatement of said logon.
12. The Applicant agrees that if personal information obtained from a Motor Vehicle Record is to be disclosed to
another person or entity, the Applicant’s organization must keep a record identifying each person or entity to whom
the information will be disclosed and the permissible use for which the information will be used. The Applicant
must keep the record for five years after the date when the information was disclosed. The Applicant will make the
record available to DMV upon demand.
13. The Applicant must not permit any other individual to use his/her assigned Motor Vehicle Record Search Logon to
obtain personal information from DMV records, nor should the Applicant share his/her assigned Motor Vehicle
Record Search Logon with any other individual.
14. The Applicant agrees to not represent oneself as an agent or employee of the DMV.
15. The Applicant understands that if the Logon has not been used during any consecutive eighteen (18) month period,
it will be terminated.
16. The Applicant agrees to comply with the provisions of the New York State Information Security Breach and
Notification Act (as set forth in General Business Law Section 899-aa, and State Technology Law Section 208)
(“ISBNA”). Authorized Users shall be liable for the costs associated with any breach of the ISBNA caused by the
Authorized User’s negligent or willful acts or omissions, or the negligent or willful acts or omissions of Authorized
User’s agents, officers, employees or subcontractors.
(A) Under the ISBNA, DMV is required to notify any individuals whose records have been accessed from a
system maintained by DMV for unauthorized purposes.
(B) The Authorized User must report suspected or confirmed violations of the DPPA or ISBNA to DMV’s Risk
Management Office via email at: nysdmvRiskManagement@dmv.ny.gov
(C) In the event that information is accessed from a system maintained by the Authorized User of personal
information provided hereunder, then the Authorized User is required to report violations of ISBNA, as
provided in the Reporting Form available on the CSCIC website at: https://its.ny.gov/eiso/breach-notification .
(D) Authorized Users must also report such violations, within one business day, to DMV’s Risk Management
Office, and must fully cooperate with DMV in the investigation of any violation, including delaying
notification to the individual to whom such information pertains if such notification would compromise a
criminal investigation.
(E) The Authorized User will defend, indemnify and hold harmless the DMV and its employees or agents from
all claims, actions, damages, or losses, including the cost of any notifications required under the ISBNA,
arising from negligent, improper, or unauthorized use or dissemination of information contained in DMV records.
17. DMV shall not be liable to the Applicant or Applicant’s organization for any damages including, but not limited to,
direct, indirect, consequential, incidental or special damages, lost savings, loss of goodwill or otherwise, or for
exemplary damages in connection with the information DMV provides to the Authorized User.
MV-15D (12/19)
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