For validation only
106-060-421-0005
ADR ADRS
X
You may either sign or type your name. By typing your name, you are certifying under penalty of perjury that you are entitled by
federal or state laws to obtain an abstract of the driver record of the individuals requested. RCW 46.52.130, 18 USC Chapter 123
Driving Record Request
Use this form to request a driving record. We will email, fax, or mail the
record(s) to you or to the individual or company you request below. Mail this
request and $13 for each record requested in a check or money order
payable to the Department of Licensing to:
Driver Records
Department of Licensing
PO Box 3907
Seattle, WA 98124-3907
Please allow two weeks for processing. If you have additional questions, contact customer service at (360) 902-3900.
Requestor information
PRINT or TYPE Requestor name (Area code) Daytime telephone number
Name of individual or company where you want the drive record(s) sent
How would you like the driving record(s) sent to you? (Choose one)
Email Fax U.S. mail (one record only)*
Delivery information (Email, [Area code] Fax number, or mailing address)
*You may select U.S. mail only if you are requesting one driver record.
I certify under penalty of perjury I am entitled by federal or state laws to obtain an abstract of the driver record of the
individual(s) requested. RCW 46.52.130, 18 USC Chapter 123
Date and place signed Signature
Drive record(s) requested
PRINT or TYPE Name (Last, First, Middle initial) Washington driver license number Date of birth (mm/dd/yyyy)
Type of record requested (Select all that apply)
Insurance records show violations, convictions, and accidents only. Other drive records show all traffic-related collisions,
convictions, violations, suspensions, revocations, and disqualifications. We offer the following types of driving records:
Noncommercial insurance record (3 year) – Used to create and renew vehicle insurance policies.
Commercial insurance record (3 year) – Used to create and renew commercial vehicle insurance policies.
Life insurance record (3 year) – Used to create and renew life insurance policies.
Employment record – Used by employers to determine employment eligibility.
Volunteer/ Transit record – Used to determine if a volunteer driver meets the insurance and risk-management
requirements to drive a vanpool vehicle or should be permitted to operate a vehicle used to transport individuals who
are under 18, over 65, or disabled.
School bus driver record – Used to determine if a person should be employed to operate a school bus.
Bill and mail this request to school district
School district authorization Requestor code
Complete record – A complete driving record of the person named on the driving record.
If requesting additional records, attach separate sheets using the same format as above. Submit $13 for each record requested.
Note: We will not mail more than one driver record. Multiple record requests will only be sent by email or fax.
We are committed to providing equal access to our services.
DR-500-009 (R/11/12)WA If you need accommodation, please call (360) 902-3900 or TTY (360) 664-0116.
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