Form OS/DS-19 "Application for Online Access to Motor Vehicle Records" - New Jersey

What Is Form OS/DS-19?

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

Form Details:

  • Released on January 1, 2017;
  • The latest edition provided by the New Jersey Motor Vehicle Commission;
  • 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 printable version of Form OS/DS-19 by clicking the link below or browse more documents and templates provided by the New Jersey Motor Vehicle Commission.

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Download Form OS/DS-19 "Application for Online Access to Motor Vehicle Records" - New Jersey

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State of New Jersey
Business & Government Services
P.O. Box 122
Trenton, N.J. 08666-0122
Phone: 609-292-4572
Application for Online Access to Motor Vehicle Records
ALL PAGES MUST BE COMPLETED AND SUBMITTED FOR YOUR REQUEST TO BE CONSIDERED. SIGNATURE IS REQUIRED
ON THE LAST PAGE.
Once completed, mail this form to the New Jersey Motor Vehicle Commission (MVC), Business & Government Services unit at the above
address. You must attach a copy of your Certification of Incorporation or, if you are a Private Investigator, a copy of your PI license. For
more information, please see our “Helpful Hints”.
Please Check One:
New Application
Revised Application
Renewal Application
Online Account #:
Company Information
Company Name:
Federal Tax ID#:
Company Phone #:
Company Fax #:
Street Address:
City:
State:
ZIP Code:
If yes, please list any other names:
YES
NO
Do you do business under
any other names?
If yes, please state when and the name of the company:
Have any of the owners/principles of this company ever had
YES
NO
their ability to obtain records from the State of New Jersey or
any other jurisdiction suspended or revoked?
If yes, please state when and the nature of the conviction:
Have any of the owners/principals of this company ever been
YES
NO
convicted of any crime arising out of fraud or improper
use/release of personal information?
If yes, please provide information in the
Do you have any subsidiary company or a parent company with subsidiary
YES
NO
“Parent Company/Subsidiary/Related
companies purchasing information directly from the MVC?
Entity” section that follows.
Nature of Business Activity:
Contact Information
Contact Administrator Name:
Driver License Number:
Company Phone #:
Company Email Address:
Street Address:
City:
State:
ZIP Code:
OS/DS-19 (R1/17)
Page 1 of 8
State of New Jersey
Business & Government Services
P.O. Box 122
Trenton, N.J. 08666-0122
Phone: 609-292-4572
Application for Online Access to Motor Vehicle Records
ALL PAGES MUST BE COMPLETED AND SUBMITTED FOR YOUR REQUEST TO BE CONSIDERED. SIGNATURE IS REQUIRED
ON THE LAST PAGE.
Once completed, mail this form to the New Jersey Motor Vehicle Commission (MVC), Business & Government Services unit at the above
address. You must attach a copy of your Certification of Incorporation or, if you are a Private Investigator, a copy of your PI license. For
more information, please see our “Helpful Hints”.
Please Check One:
New Application
Revised Application
Renewal Application
Online Account #:
Company Information
Company Name:
Federal Tax ID#:
Company Phone #:
Company Fax #:
Street Address:
City:
State:
ZIP Code:
If yes, please list any other names:
YES
NO
Do you do business under
any other names?
If yes, please state when and the name of the company:
Have any of the owners/principles of this company ever had
YES
NO
their ability to obtain records from the State of New Jersey or
any other jurisdiction suspended or revoked?
If yes, please state when and the nature of the conviction:
Have any of the owners/principals of this company ever been
YES
NO
convicted of any crime arising out of fraud or improper
use/release of personal information?
If yes, please provide information in the
Do you have any subsidiary company or a parent company with subsidiary
YES
NO
“Parent Company/Subsidiary/Related
companies purchasing information directly from the MVC?
Entity” section that follows.
Nature of Business Activity:
Contact Information
Contact Administrator Name:
Driver License Number:
Company Phone #:
Company Email Address:
Street Address:
City:
State:
ZIP Code:
OS/DS-19 (R1/17)
Page 1 of 8
State of New Jersey
Business & Government Services
P.O. Box 122
Trenton, N.J. 08666-0122
Phone: 609-292-4572
Application for Online Access to Motor Vehicle Records
Accessing Information
Individual Requests
Batch Requests (250+ = Batch)
Will You Be Requesting (please select one)?
OR
Driver
Registration Inquiry
Title History
Title Inquiry
Driver Status
Type of Access Required
History
(Rental Car & School Bus
(select all applicable)
Companies Only)
In your own words, state your
intended use of information
obtained from the Motor Vehicle
Commission (please be
specific).
Anticipated Number of
Employees that will access the
Office
Home
Both
Online System:
How Will Users Access the MVC
Online System?
(Please provide a complete list
of employees who will have
access)
If answering yes, you will be required to provide:
a) A list of your clients mailed to the above address or emailed in MS Excel format to
MVC.CAIR@mvc.nj.gov.
Are you reselling the MVC
YES
NO
records that you obtain?
b) A separate document detailing the procedures/methods you will use to monitor the use of
the information to ensure that your client(s) comply with the NJ State and federal Driver
Privacy Protection Acts.
Parent Company / Subsidiary / Related Entity Information
Company Name Shown on MVC Application:
MVC CAIR Account Number (if applicable):
Relationship to Your Company:
Street Address:
City:
State:
ZIP Code:
Is this business now or has it ever been
Has this business ever had its ability to
YES
NO
YES
NO
suspended from purchasing MVC
purchase MVC information permanently
information?
revoked?
Company Name Shown on MVC Application:
MVC CAIR Account Number (if applicable):
Relationship to Your Company:
Street Address:
City:
State:
ZIP Code:
OS/DS-19 (R1/17)
Page 2 of 8
State of New Jersey
Business & Government Services
P.O. Box 122
Trenton, N.J. 08666-0122
Phone: 609-292-4572
Application for Online Access to Motor Vehicle Records
Is this business now or has it ever been
Has this business ever had its ability to
YES
NO
YES
NO
suspended from purchasing MVC
purchase MVC information permanently
information?
revoked?
Are there more than two
YES
NO
companies? (Please attach
additional pages)
OS/DS-19 (R1/17)
Page 3 of 8
State of New Jersey
Business & Government Services
P.O. Box 122
Trenton, N.J. 08666-0122
Phone: 609-292-4572
Application for Online Access to Motor Vehicle Records
NEW JERSEY MOTOR VEHICLE COMMISSION TECHNOLOGY QUESTIONNAIRE
Company Name:
MVC CAIR Account Number (if renewing):
Name of Company Representative:
Title of Company Representative:
Phone Number:
The New Jersey Motor Vehicle Commission (MVC) requires that customers of the CAIR (Customer Abstract Information Retrieval)
program perform due diligence in their protection of any information and data obtained through the program. The protection of this
information and data is of the utmost importance for the MVC. The sensitivity of this data and the increase of identity theft requires that
we partner with you to ensure that MVC and you meet our obligations under the Driver Privacy Protection Act (DPPA) and that your
technology environment meets both Federal Information Security Act (FISMA) and the National Institute of Standards and Technology
(NIST) standards. The terms and conditions related to protection of this information and data can be found within the CAIR agreement.
Applicants of the CAIR program must be able to demonstrate their ability to comply with these terms and conditions.
Please complete this questionnaire and submit it with your application. All parts must be completed. Do not leave blanks. If something
is not applicable, please indicate this on the questionnaire and explain why. If you need more space to provide the information requested,
indicate so next to the question and attach additional pages. All pages of this questionnaire must be returned.
Scope of the questionnaire
All MVC PII data held in electronic format or contained within a structured manual filing system must be audited. In particular, but not
exclusively, the audit will cover PII data held in the following systems and formats:
Personal Computer
Databases
Servers
Virtual Machines
Cloud Services
Document management systems (including documents stored in standard directory structures provided by such facilities as
CFS)
Individual computer files where appropriate e.g. spreadsheets and other such analysis tools, word-processed lists;
Structured e-mail directories
Structured manual filing systems that can be referenced by individual e.g. Student files, staff files, survey data forms,
examination scripts, holiday charts/lists, directories, publication lists;
Web-pages
Microfiche
CD's
Thumb drives or memory sticks
Any other storage devices not listed here
Please note that in conducting the audit it will be necessary to meet with all staff within your organization to ensure that PI and PII is
uniformly being handled according to the aforementioned standards.
Definitions
Driver's Privacy Protection Act (DPPA) is a federal and State law that limits the occasions when state departments of motor vehicles
and authorized recipients may disclose to the public personal information contained in a person's motor vehicle record, which includes a
motor vehicle operator's permit, motor vehicle title, motor vehicle registration, or identification card issued by a department of motor
vehicles. Many states have enacted similar legislation further regulating this data.
Personal Information (PI) means information that identifies an individual, including an individual's photograph; social security number;
driver identification number; name; address other than the five-digit zip code; telephone number; and medical or disability information,
but does not include information on vehicular accidents, driving violations, and driver's status.
OS/DS-19 (R1/17)
Page 4 of 8
State of New Jersey
Business & Government Services
P.O. Box 122
Trenton, N.J. 08666-0122
Phone: 609-292-4572
Application for Online Access to Motor Vehicle Records
Personally Identifiable Information (PII) means information which can be used to distinguish or trace an individual's identity, such as
their name, social security number, biometric records, etc. alone, or when combined with other personal or identifying information which
is linked or linkable to a specific individual, such as date and place of birth, mother’s maiden name, etc.
NEW JERSEY MOTOR VEHICLE COMMISSION TECHNOLOGY QUESTIONNAIRE (cont.)
Questions
Users Access:
Q1. If you are renewing your application, provide a list of the users in your organization that have access to MVC's CAIR system.
Please be advised that each user MUST have their own logon ID.
(If necessary, attach a separate sheet of paper)
Name:
E-Mail Address:
Logon ID:
Operating System:
Q2. What OS (Operating System) version(s) are your servers, laptops and PC's utilizing? If you are not running the latest version(s),
do you have plans and a timetable to upgrade? If yes, what are your plans and a timetable to upgrade?
Anti-Virus|Spyware:
Q3. What Anti-Virus and related software are you currently utilizing and what version(s)? If you are not running the latest version(s),
do you have plans and a timetable to upgrade? If yes, what are your plans and a timetable to upgrade?
Q4. When accessing or manipulating MVC’s data, is your organization logging the Anti-Virus, Anti-Spyware, or Anti-Malware events
from your servers, laptops, PC’s, or any other device?
Q5. Does your organization periodically assess security controls within your information system(s)? If so, how often and what industry
standards are you following?
Security:
Q6. If there is a data breach, what is your incident response procedure?
Q7. Based on the provisions of the
Drivers’ Privacy Protection Act (DPPA), how
is your organization planning to protect Motor Vehicle
Commission’s PI and PII data? In the event PI and PII data has been lost, leaked or mishandled, what is your organization’s
current process in notifying motor vehicle departments?
OS/DS-19 (R1/17)
Page 5 of 8
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