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Driver Record Alert Request Form - Michigan

Enforcement Division - Fraud Investigations Section 3044 W. Grand Blvd. Suite 6-400 Detroit, MI 48202 Fax: 313-456-0670 ** IMPORTANT ** PLEASE KEEP A COPY OF THIS COMPLETED REQUEST FORM FOR YOUR RECORDS Michigan driver’s license / PID card number: Birth date: Contact information (Phone/email): Signature: Request date: Printed name:


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