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Notarized Authorization to Release Personal Motor Vehicle ...

Notarized Authorization to Release Personal Motor Vehicle Information Visit us at New Jersey is an Equal Opportunity Employer DO-21A (R10/19) I, _____ grant permission to _____ to (Name of Grantor) (Name of Recipient) receive my Personal driver history record and any other Motor Vehicle information requested by _____ deemed appropriate by the Motor Vehicle Commission for (Name of recipient) Release under the New Jersey Driver s Privacy Protection Act, et seq. _____ _____ Signature of Grantor Driver s License Number of Grantor _____ _____ Street Address Date _____ City, State, Zip Code This form, when properly completed and signed, will be accepted by the New Jersey Motor Vehicle Commission as satisfactory Authorization to Release Personal Motor v

Budget Briefing Book FY13 Schedule Author: TPZSAB3 Created Date: 12/6/2019 9:20:19 AM ...

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