"Driving Record Alert Request Form" - Michigan

Driving Record Alert Request Form is a legal document that was released by the Michigan Department of State - a government authority operating within Michigan.

Form Details:

  • Released on August 1, 2021;
  • The latest edition currently provided by the Michigan Department of State;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Michigan Department of State.

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CLEAR FORM
Driving Record Alert Request Form
Please read and understand the following information before requesting an alert on your driving record:
A Michigan Department of State (MDOS) driving record alert is NOT designed to prevent identity fraud or theft.
Please refer to the bottom of this form for other information and resources on identity fraud or theft.
The purpose of the MDOS driving record alert is to notify law enforcement that someone else may be using your
name during traffic stops. If so, the alert still may not prevent this activity.
Traffic tickets cannot be removed from your driving record without specific court approval. If traffic tickets were wrongly
attributed to your record, you must contact the courts involved to dispute the entries.
Your driver’s license or personal identification card number will not be changed in cases of identity theft or fraud.
After receipt of this completed form, it may take up to 30 days to establish the alert on your driving record. Once
applied, the flash “Verify Subject’s Identity” will appear on your driving record for seven years unless you request in
writing to have it expunged earlier. After seven years another alert application is required. Be advised that while on
your record, this alert may require that you provide sufficient proof of identity during a traffic stop.
To check whether the alert is on your record, you may contact the Michigan Department of State Information
Center toll free at 888-767-6424; Monday through Friday from 8:30 a.m. to 5 p.m.
With appropriate identification, you may immediately purchase a copy of your driving record at any Secretary of
State office for $12. You also can request a copy of your driving record for $11 via mail or fax by using the BDVR
-154, Non-Account Record Lookup Request form available online at
Michigan.gov/SOS - publications and
forms.
To place a verify subject’s Identity alert on your driving record, legibly complete all the information below:
Reasons for requesting the alert (please be specific):
Signature:
Request date:
Printed name:
Michigan driver’s license / PID card number:
Birth date:
Contact information (Phone/email):
For further protection and by initialing the box to the left, I give the Michigan Department of State my permission to share
the information on this form with other state of Michigan investigative sections as allowed by law for fraud detection and
mitigation purposes.
Michigan Department of State
Enforcement Division - Fraud Investigations Section
** IMPORTANT **
3044 W. Grand Blvd.
PLEASE KEEP A COPY OF THIS
Send this completed form to:
Suite 6-400
COMPLETED REQUEST FORM
Detroit, MI 48202
FOR YOUR RECORDS
Fax:313-456-0670
Other Identity Fraud/Theft Information
If you believe you are a victim of identity theft or fraud, you are encouraged to contact your local law enforcement agency and
any of the organizations listed below for more information:
Michigan State Police (Michigan.gov/MSP)
Michigan Attorney General
(Michigan.gov/AG)
Experian (888) 397-3742 or
experian.com
Equifax 800-525-6285 or
equifax.com
Trans Union (800) 680-7289 or
transunion.com
Telecheck 800-710-9898 or
telecheck.com
Federal Trade Commission 877-438- 4338 or
ftc.gov
Revised 08/2021
PRINT
CLEAR FORM
Driving Record Alert Request Form
Please read and understand the following information before requesting an alert on your driving record:
A Michigan Department of State (MDOS) driving record alert is NOT designed to prevent identity fraud or theft.
Please refer to the bottom of this form for other information and resources on identity fraud or theft.
The purpose of the MDOS driving record alert is to notify law enforcement that someone else may be using your
name during traffic stops. If so, the alert still may not prevent this activity.
Traffic tickets cannot be removed from your driving record without specific court approval. If traffic tickets were wrongly
attributed to your record, you must contact the courts involved to dispute the entries.
Your driver’s license or personal identification card number will not be changed in cases of identity theft or fraud.
After receipt of this completed form, it may take up to 30 days to establish the alert on your driving record. Once
applied, the flash “Verify Subject’s Identity” will appear on your driving record for seven years unless you request in
writing to have it expunged earlier. After seven years another alert application is required. Be advised that while on
your record, this alert may require that you provide sufficient proof of identity during a traffic stop.
To check whether the alert is on your record, you may contact the Michigan Department of State Information
Center toll free at 888-767-6424; Monday through Friday from 8:30 a.m. to 5 p.m.
With appropriate identification, you may immediately purchase a copy of your driving record at any Secretary of
State office for $12. You also can request a copy of your driving record for $11 via mail or fax by using the BDVR
-154, Non-Account Record Lookup Request form available online at
Michigan.gov/SOS - publications and
forms.
To place a verify subject’s Identity alert on your driving record, legibly complete all the information below:
Reasons for requesting the alert (please be specific):
Signature:
Request date:
Printed name:
Michigan driver’s license / PID card number:
Birth date:
Contact information (Phone/email):
For further protection and by initialing the box to the left, I give the Michigan Department of State my permission to share
the information on this form with other state of Michigan investigative sections as allowed by law for fraud detection and
mitigation purposes.
Michigan Department of State
Enforcement Division - Fraud Investigations Section
** IMPORTANT **
3044 W. Grand Blvd.
PLEASE KEEP A COPY OF THIS
Send this completed form to:
Suite 6-400
COMPLETED REQUEST FORM
Detroit, MI 48202
FOR YOUR RECORDS
Fax:313-456-0670
Other Identity Fraud/Theft Information
If you believe you are a victim of identity theft or fraud, you are encouraged to contact your local law enforcement agency and
any of the organizations listed below for more information:
Michigan State Police (Michigan.gov/MSP)
Michigan Attorney General
(Michigan.gov/AG)
Experian (888) 397-3742 or
experian.com
Equifax 800-525-6285 or
equifax.com
Trans Union (800) 680-7289 or
transunion.com
Telecheck 800-710-9898 or
telecheck.com
Federal Trade Commission 877-438- 4338 or
ftc.gov
Revised 08/2021