Transcription of Form 4678 - Request for DPPA Security Access Code
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Form 4678 - Request for DPPA Security Access Code
Form4678 Missouri Department of RevenueRequest for DPPA Security Access CodeForm 4678 (Revised 01-2018)Office Use OnlySecurity code Assigned _____This form must be fully completed and approved before a Requester can obtain Access to restricted information. Only Requesters who meet the criteria outlined in the Purpose of Request section below are eligible to obtain restricted information and a Security Access code . Incomplete forms will be returned for more information. Appropriate documentation must be submitted with this form to verify your eligibility to receive information under the provisions of the federal Driver s Privacy Protection Act (DPPA) and Missouri law, including but not limited to, business license, insurance license, bar car
Security Code Assigned _____ This form must be fully completed and approved before a Requester can obtain access to restricted information. Only Requesters who meet the criteria outlined in the Purpose of Request section below are eligible to obtain restricted information and a security access code. Incomplete forms will
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