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NON ACCOUNT & INDIVIDUAL RECORD

MICHIGAN DEPARTMENT OF STATE RECORD LOOKUP REQUEST INSTRUCTIONS FOR COMPLETING THIS FORM General Information Lookups of driving, personal identification and vehicle records are available for $ for each RECORD lookup. Certifi cations cost an additional $ per RECORD . If no RECORD is found, you are still responsible for paying t he lookup fee(s). Fill out a s much information about your request a s yo u can. Accurate and complete informati on will help us lo cate the RECORD (s) you want. Please include a daytime telephone number in case we have questions about your request.

History requests are $11.00 per record search (all histories can be significantly more than $11.00) ... understand that the willful unauthorized disclosure of information obtained from these records for a purpose other than stated on this request, or the ... motorvehicle or public safety. M.

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