735 48

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DMV
DMV SERVICES
1905 LANA AVE NE
SALEM OR 97314-2340

DEPARTMENT OF TRANSPORTATION
DRIVER AND MOTOR VEHICLE SERVICES
1905 LANA AVE NE, SALEM OREGON 97314

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PRE-ADDRESSED -- FOLD AND MAIL IN STANDARD #10 WINDOW ENVELOPE

REQUEST FOR DRIVING RECORD*
*This form can ONLY be used by DMV account holders. If you do not have a Records Inquiry Account with DMV,
please use DMV form titled Order Your Own Record (form number 735-7266).
REQUESTOR’S DMV ACCOUNT NUMBER

DR

DATE OF REQUEST

CS

NON-EMPLOYMENT DRIVING RECORD = 3 -YEAR RECORD - $1.50

SUSPENSION PACKAGE - $11.50
COURT DATE: ______________________________

DE

EMPLOYMENT DRIVING RECORD = 3 -YEAR RECORD - $2.00

ARS

AUTOMATED REPORTING SYSTEM - $2.00
ADD
DELETE

DI

DRIVER ADDRESS INFORMATION - $1.50

DO

OPEN-ENDED NON-EMPLOYMENT DRIVING RECORD - $1.50
(Only available to insurers and insurance support organizations)

CP

CERTIFIED COURT PRINT = THIS OPTION MAY INCLUDE MORE
THAN FIVE YEARS OF RECORD INFORMATION. - $3.00

PA

POLICE TRAFFIC CRASH REPORT RECORD - $8.50
(For PA Requests see important information below.)

MQ

CERTIFIED COURT PRINT with CDL MEDICAL CERTIFICATION
INFORMATION = MAY INCLUDE MORE THAN FIVE YEARS OF
RECORD INFORMATION. - $3.00

ODL / CUSTOMER NUMBER

DATE OF BIRTH
(MONTH-DAY-YEAR)

OTHER (Specify): ____________________________

NOTE: See DMV form # 735-6691 for additional record types
DRIVER’S NAME
(LAST, FIRST, MIDDLE)

– FOR SUSP. PACKAGE (CS) ONLY –
ARREST DATE

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An $8.50 fee will be charged even when the DMV Police Traffic Crash Report can not be found. If the information below is not provided, your request will not
be processed and returned back to you. For Accident Information Letters, you must attach a statement of representation and how your client was involved.
Requests for police reports regarding automobile accidents must contain the following information:
Date of Accident: _____________________
County (or nearest city if county unknown): ________________________________
Driver Information (name, date of birth, Oregon license number if available): ________________________
RETURN INFORMATION BY:
ATTENTION

FAX #

MAIL

COMPANY NAME:

COMPANY

(

)

STREET ADDRESS

CITY, STATE, ZIP CODE

735-48 (11-15)

Please Note: If more than 30 records are requested during one business day,
your records will automatically be mailed to the mailing address associated
with your account.
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Create Date                     : 2015:12:07 14:36:36-08:00
Modify Date                     : 2015:12:07 14:37:03-08:00
Subject                         : Request for Driving Record
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