Form DMV07-06A "Application for Copy of Driving Record" - Nebraska

What Is Form DMV07-06A?

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

Form Details:

  • Released on August 1, 2017;
  • The latest edition provided by the Nebraska 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 printable version of Form DMV07-06A by clicking the link below or browse more documents and templates provided by the Nebraska Department of Motor Vehicles.

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Download Form DMV07-06A "Application for Copy of Driving Record" - Nebraska

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Prosecuting Agency
Application for Copy of Driving Record
§60-483
The availability of records is subject to the provisions of the Uniform Motor Vehicle Records Disclosure Act.
Your signature must be notarized and the appropriate fees included or the request will be returned to you
unprocessed.
Indicate clearly if your request is for a Transcript or Certified Record. A transcript is any information in an
individual’s file regarding a suspension or notice of suspension and includes the driving record. A certified record is
the driving record only. If you request a transcript but only receive a record no transcript is available. If no record is
available you will receive a certified statement to that effect. Processing time for a transcript request is three (3)
weeks. Please allow for this time period when submitting your requests.
PLEASE PRINT
-- Form MUST be completed in full. --
Name (as appears on driver license):
Date of Birth:
Nebraska Driver License Number:
Name and Date of Birth OR Name and Nebraska Driver’s License Number must be provided to perform a record check.
Transcript ($4.00 fee)
Date of arrest:
Please mark one.
(Suspension file)
Certified Driving Record ($3.00 fee)
For what purpose will this record be used? Number of applicable exempted use:
(Required)
See reverse side for exempted uses. If the purpose of your request fails to meet one of the exempted uses allowed the record will
not be disclosed without the notarized signature of the record holder.
Requestors Name:
Phone:
Agency Name:
Email:
Address:
City, State, Zip:
Under penalty of law, the undersigned certifies that the information contained on the driving record being purchased will only be
used as authorized by the Uniform Motor Vehicle Records Disclosure Act. The undersigned hereby acknowledges that this request
is made with the understanding that any person requesting disclosure of personal information from the Department of Motor
Vehicle records who misrepresents his or her identity, misrepresents the purpose for which the information requested will be used,
or otherwise makes a false statement on this application shall be guilty of a class IV felony.
Requestor Signature:
Date:
Signature must be notarized in the area below.
State of
County of
The foregoing signature of the requestor was acknowledged before me this
day of
,
.
Notary Public
Seal
Return to:
Driver and Vehicle Records Division
Nebraska Department of Motor Vehicles
Transcript Requests
A stamped self-addressed envelope is
required for all mail-in requests.
PO Box 94789
Lincoln, NE 68509-04789
DMV 07-06a 8/17
Prosecuting Agency
Application for Copy of Driving Record
§60-483
The availability of records is subject to the provisions of the Uniform Motor Vehicle Records Disclosure Act.
Your signature must be notarized and the appropriate fees included or the request will be returned to you
unprocessed.
Indicate clearly if your request is for a Transcript or Certified Record. A transcript is any information in an
individual’s file regarding a suspension or notice of suspension and includes the driving record. A certified record is
the driving record only. If you request a transcript but only receive a record no transcript is available. If no record is
available you will receive a certified statement to that effect. Processing time for a transcript request is three (3)
weeks. Please allow for this time period when submitting your requests.
PLEASE PRINT
-- Form MUST be completed in full. --
Name (as appears on driver license):
Date of Birth:
Nebraska Driver License Number:
Name and Date of Birth OR Name and Nebraska Driver’s License Number must be provided to perform a record check.
Transcript ($4.00 fee)
Date of arrest:
Please mark one.
(Suspension file)
Certified Driving Record ($3.00 fee)
For what purpose will this record be used? Number of applicable exempted use:
(Required)
See reverse side for exempted uses. If the purpose of your request fails to meet one of the exempted uses allowed the record will
not be disclosed without the notarized signature of the record holder.
Requestors Name:
Phone:
Agency Name:
Email:
Address:
City, State, Zip:
Under penalty of law, the undersigned certifies that the information contained on the driving record being purchased will only be
used as authorized by the Uniform Motor Vehicle Records Disclosure Act. The undersigned hereby acknowledges that this request
is made with the understanding that any person requesting disclosure of personal information from the Department of Motor
Vehicle records who misrepresents his or her identity, misrepresents the purpose for which the information requested will be used,
or otherwise makes a false statement on this application shall be guilty of a class IV felony.
Requestor Signature:
Date:
Signature must be notarized in the area below.
State of
County of
The foregoing signature of the requestor was acknowledged before me this
day of
,
.
Notary Public
Seal
Return to:
Driver and Vehicle Records Division
Nebraska Department of Motor Vehicles
Transcript Requests
A stamped self-addressed envelope is
required for all mail-in requests.
PO Box 94789
Lincoln, NE 68509-04789
DMV 07-06a 8/17
The exempted uses permitted under N.R.S. §60-2901 to §60-2912, the Uniform Motor Vehicle Records
Disclosure Act, are as follows:
1. Use by any federal, state, or local governmental agency, including any court or law enforcement
agency, in carrying out its functions, or by any private entity acting on behalf of an agency in carrying
out their functions.
2. Use in connection with vehicle or driver safety and theft; vehicle emissions; vehicle product alterations,
recalls or advisories; performance monitoring of vehicles, vehicle parts, and dealers; motor vehicle
market research activities and survey research; and removal of non-owner records from the original
owner records of motor vehicle manufacturers.
3. Use in normal course of business by a legitimate business to verify accuracy of information submitted
by an individual or business; or to obtain correct information if the above is not correct or no longer
correct, for the purpose of preventing fraud, pursuing legal remedies against or recovering on a debt or
security interest against the record holder.
4. Use in connection with a civil, criminal, administrative or arbitral proceeding in any federal, state or
local court, government agency, or self-regulatory body, including service of process, investigation in
anticipation of litigation, and execution or enforcement of judgment; or pursuant to an order of a
federal, state, or local court, an administrative agency, or a self-regulatory body.
5. Use in research activities and statistical reports, as long as personal information is not published,
redisclosed or used to contact individuals.
6. Use by any insurer/insurance support organization or by a self-insured entity in connection with claims
investigation activities, anti-fraud activities, rating or underwriting.
7. Use in providing notice to owners of abandoned, towed or impounded vehicles.
8. Use by a private detective, plain clothes investigator, or private investigative agency licensed under
N.RS. §71-3201 to §71-3213 for purposes permitted under this act.
9. Use by an employer, employer’s agent or insurer, to obtain or verify information of a holder of a
Commercial Driver License or Commercial Learner Permit.
10. Use in connection with the operation of private toll transportation facilities.
11. Any use if requestor has notarized consent of the record holder and has provided proof of such consent
to the Department, as indicated on the front of this form.
12. Use, including redisclosure through news publication, for a member of a medium of communication as
defined in N.R.S. §20-145, in connection with news involving motor vehicle or driver safety or vehicle
theft.
13. Any use if the request for the record is made by the record holder.
14. For use by the federally designated organ procurement organization in Nebraska to establish and
maintain the Donor Registry of Nebraska.
15. For use to fulfill the requirements of the electronic dealer services system.
16. For any other use specifically authorized by law and related to the operation of a motor vehicle or
public safety.
Redisclosure
A recipient of a motor vehicle record may only resell or redisclose the information obtained if for one of the
uses permitted under the Uniform Motor Vehicle Records Disclosure Act. You shall make and keep for 5
years, records identifying each person to whom you redisclosed the information and the permitted purpose
for which it was redisclosed. These records shall be made available for inspection and copying by a
representative of the Department of Motor Vehicles upon request.
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