MVRRequestCreate

The University of Alabama

Motor Vehicle Record (MVR) Release Form

		Is driver high risk?
Relationship		Other

Driver's Full Name*		Driver's CWID:
* As it appears on Driver's License
Driver's Date of Birth: Type a date/Select a date ...		Driver's Email Address:
Driver's License Number (Not Tag Number):		State of Issuance:
* If licensed in the current state for less than 3 years, provide prior license number and state of issuance.

Please provide the approximate date and a brief description of any accidents where you were the driver of an involved vehicle and another driver was determined to be at-fault.
Type a description

By checking this box, I indicate my understanding of the information shown on this form, and it is my intent to sign the record. I certify that I am the individual stated and my answers are complete and correct.

Department Information
Department:		Manager/Supervisor:Lookup
Phone Number:		Campus - P.O. Box:
Manager/Supervisor/Contact Email Address:

Within 30 days of being approved, all drivers must complete the General Driver Safety Training course. The course can be found on the Risk Management website (riskmanagement.ua.edu).

Any driver that may operate a van with a capacity of 9 or more (including driver) must take an online safety training course. Contact Zachary Dutton to obtain the online access information.