You have requested to obtain a Motor Vehicle Report (driving record) for the
District of Columbia

Step 1. Please print this out

Step 2. Fill out the form completely

Step 3. Have the APPLICANT SIGN AND DATE the form

Step 4. Fax the completed form to I-NEX Solutions, Inc. at

fax (813) 968-2195

Step 5. The records can NOT be searched until this form is received by I-NEX

Form on next page

DC Drive Authorization

I, _____________________________________, do hereby authorize the

Division of Motor Vehicles to release my driving record to

___________________________________________________________

This release shall remain in full force and effect until I, myself file formal

Withdrawal.

Driver’s Full Name: _____________________________

Date of Birth:___________________________________

DL#: _________________________________________

_________________________
Signature

  _________________________
Date