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The Missouri 4681 form is a crucial document for individuals needing to request their driver license records or other personal information as held by the state. Record holders are required to approve the release by completing, signing, and notarizing this form; otherwise, requests will be denied. For those looking for a quicker way to access non-restricted driver record information, options include the official website or visiting a local license office.

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The Missouri 4681 form serves as a crucial document for individuals seeking to access or release their driver license records or other documents containing their personal information. The form is designed to safeguard individuals' privacy by requiring record holders to provide explicit approval before any personal data is shared. This process involves the completion, signing, and notarization of the form, reinforcing the state's commitment to protecting personal information. Moreover, the form provides a pathway for accessing non-restricted Missouri driver record information through a more streamlined online service or in-person requests at local license offices. Detailed within the form are sections for personal and non-personal information, which delineate between more sensitive data such as social security numbers, photographs, and contact details, and less sensitive data that includes driving history and zip code. Additionally, the form outlines various services available to the requester, including obtaining a driver record, clearance letter, image portfolio, and temporary driving privilege, along with specifying methods of delivery for the requested documents. The financial aspect is also addressed, listing the fees associated for record retrieval and the convenience fees for credit or debit card transactions, thereby providing a comprehensive overview of the procedural and financial aspects involved in requesting driver license records in Missouri.

Preview - Missouri 4681 Form

Form

4681

Request From Driver License Record Holder

 

Record holders must approve the release of driver license records or other documents containing personal information. To request such records this form must be completed, signed and notarized or the request will be denied. For a faster and more convenient way to obtain a copy of non-restricted Missouri driver record information visit mydmv.mo.gov/ and select Driver License Services, or visit a local license office. Personal information includes the person’s name, address, date of birth, sex, height, weight, eye color, driver license number, social security number, photograph, and telephone number. Non-Personal information may include the person’s first and last name, driving history, and zip code.

Holder’sRecord Information

 

First Name

 

Middle Initial

Last Name

 

 

 

 

 

 

 

 

 

 

 

 

Date of Birth (MM/DD/YYYY)

Missouri Driver License or Social Security Number

 

Daytime Telephone Number

 

 

 

 

 

___ ___ / ___ ___ / ___ ___ ___ ___

 

 

 

 

(___ ___ ___)___ ___ ___-___ ___ ___ ___

 

 

Mailing Address

City

State

Zip Code

E-Mail Address

 

 

 

 

 

 

 

 

 

Driver License

Records

 

 

 

 

Mailing & Fax

Information

 

 

Payment Options and Signature

Notary Information

r Driver Record

r Clearance Letter (No Fee Required)

r Image Portfolio (Black and White Photo)

r Temporary Driving Privilege (No Fee Required)

rOther (Specify) _____________________________________________________________________________________

Would you like the requested records to be sent somewhere other than to the record holder’s address? r Yes r No

If yes, how would you like it to be sent? r Mail (provide alternate mailing address) r Fax (add $0.50 per page faxed; provide fax number)

rE-mail ______________________________________

Name

Agency Name (If Applicable)

Fax Number

(___ ___ ___)___ ___ ___-___ ___ ___ ___

Address

City

State

Zip Code

 

 

 

 

Records can be obtained by walk-in, mail-in, or e-mail request. The fee is $2.82 per record. A convenience fee will be charged for credit or debit card transactions. The Missouri Department of Revenue may electronically resubmit checks returned for insufficient or uncollected funds. You may visit us at Central Office, Harry S Truman Building, Room 470, 301 West High Street, Jefferson City, Missouri.

Cash

Check

Money

Debit

Discover

Visa

American

Mastercard

Order

Card

Express

 

 

 

 

 

 

 

 

 

 

 

 

 

Central Office Visit

Mail

Fax

If you are paying by credit or debit card you must provide the following:

Name (as it appears on card)

Card Number

Expiration Date

 

 

__ __ / __ __

 

 

 

Under penalties of perjury, I declare that the above information and any attached supplement is true, complete, and correct. I authorize the Department of Revenue to send the requested record where I designated above.

 

 

 

 

 

 

 

Record Holder’s Signature

 

 

Date (MM/DD/YYYY)

 

 

 

 

 

 

 

 

 

 

___ ___ / ___ ___ / ___ ___ ___ ___

 

 

 

 

 

 

 

 

 

 

 

 

 

Embosser or black ink rubber stamp seal

Subscribed and sworn before me, this

 

 

 

 

 

day of

 

year

 

 

 

 

 

 

 

 

State

County (or City of St. Louis)

 

My Commission Expires (MM/DD/YYYY)

 

 

 

 

 

___ ___ /___ ___ /___ ___ ___ ___

 

 

 

 

 

 

 

 

Notary Public Signature

 

 

 

 

 

 

 

 

 

 

Notary Public Name (Typed or Printed)

 

 

 

 

 

 

 

 

Mail to:

Driver License Bureau

E-mail: dlrecords@dor.mo.gov

Form 4681 (Revised 09-2022)

 

DL Record Center

Visit dor.mo.gov/driver-license/ for additional information.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

P.O. Box 2167

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Jefferson City, MO 65105-2167

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone:

(573) 526-2407

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Fax:

(573) 526-7367

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

File Properties

Fact Name Description
Form Purpose The Missouri Form 4681 is used to request the release of driver license records or other documents containing personal information held by the Missouri Department of Revenue.
Notarization Requirement For a request to be processed, Form 4681 must be completed, signed, and notarized; otherwise, the request will be denied.
Alternative Options for Record Access Records can be obtained faster and more conveniently online at https://mydmv.mo.gov/ under Driver License Services, or by visiting a local license office, bypassing the need for form submission.
Content of Records The records may include personal information such as the individual’s name, address, and driver license number, as well as non-personal information like driving history.
Governing Law Requests and release of driver license records are governed by Missouri laws which dictate the conditions under which personal and non-personal information may be released.

How to Fill Out Missouri 4681

Filling out the Missouri 4681 form is an essential step for individuals needing to request their driver license records or documents containing personal information. This process requires attention to detail and accuracy to ensure that your request is processed without delay. Follow the steps below carefully to complete your form properly.

  1. Start by clearly printing your First Name, Middle Initial, and Last Name as registered with the Missouri Department of Revenue.
  2. Enter your Date of Birth in the format MM/DD/YYYY.
  3. Provide either your Missouri Driver License or Social Security Number, depending on which identifier you prefer to use for this request.
  4. Fill in your Daytime Telephone Number, including the area code.
  5. Write your complete Mailing Address, including City, State, and Zip Code.
  6. Add your E-Mail Address to ensure you can be contacted electronically, if necessary.
  7. Select the type of document you are requesting by checking the appropriate box (Driver Record, Clearance Letter, Image Portfolio, Temporary Driving Privilege, or Other). If Other, specify the document in the space provided.
  8. Indicate whether you would like the records sent to an alternate address, by fax, or email by checking Yes or No and providing the requested details.
  9. Choose your payment method and fill in the necessary payment information. If paying by credit or debit card, include the Name (as it appears on the card), Card Number, and Expiration Date.
  10. Review all the information you've provided for accuracy.
  11. Sign and date the form in the space provided, acknowledging under penalties of perjury that your information is true and correct.
  12. Have the form notarized to validate your identity. The notary will fill out their section, which includes the Notary Public Signature, Notary Public Name (typed or printed), and the expiration of their commission.
  13. Finally, mail, fax, or email the completed and notarized form to the provided contact information for the Driver License Bureau.

Once your form is submitted, the Missouri Department of Revenue will process your request for the specified records. Keep in mind that processing times may vary, and ensuring your form is accurately completed and notarized can help avoid delays. If you have questions about your request or encounter issues filling out the form, consider reaching out directly to the Driver License Bureau for assistance.

Understanding Missouri 4681

What is the Missouri 4681 form used for?

The Missouri 4681 form is a formal request used by individuals to obtain records or documents containing their personal information from their driver license record. It requires the record holder to consent to the release of these records, which can include personal details such as name, address, driver license number, and more. This form must be completed, signed, and notarized for the request to be processed.

How can someone obtain a copy of their non-restricted Missouri driver record information?

For those looking to obtain a copy of their non-restricted Missouri driver record information, there are several convenient options available. Individuals can either:

  • Visit the online platform at https://mydmv.mo.gov/ and select "Driver License Services" or,
  • Go to a local license office in person.

These methods provide a faster and more convenient way to access driver record information than submitting a request through mail or walk-in.

What types of records can be requested with the Missouri 4681 form?

With the Missouri 4681 form, individuals can request various types of documents, including but not limited to:

  1. Driver Record
  2. Clearance Letter (No Fee Required)
  3. Image Portfolio (Black and White Photo)
  4. Temporary Driving Privilege (No Fee Required)
  5. Other (Specific records as requested by the individual)

What are the payment options for requesting records using the Missouri 4681 form?

When requesting records using the Missouri 4681 form, several payment options are available. These include:

  • Money Order
  • Cash (only applicable for in-person requests)
  • Check
  • Debit Card
  • Credit Card (American Express, Discover, Visa, Mastercard)

Note that a convenience fee is charged for credit or debit card transactions. The fees for records vary based on the method of ordering (walk-in, mail, fax, or e-mail).

How can the requested records be sent to someone other than the record holder?

If the requestor wishes for the records to be sent to an address different from that of the record holder's, they must indicate this preference on the Missouri 4681 form. They have the option to choose the records to be sent via:

  • Mail (by providing an alternate mailing address)
  • Fax (with an additional $0.50 per page faxed; fax number must be provided)
  • Email (by specifying an email address)

This flexibility allows for the records to be received by a designated third party, such as an agency or legal representative, if necessary.

Common mistakes

When filling out the Missouri 4681 form, which is necessary for requesting driver license records, individuals often overlook or incorrectly handle several key aspects. These mistakes can lead to delays or the denial of the request. Understanding and avoiding these common errors ensures the process goes smoothly and efficiently. Here's a breakdown of seven common mistakes:

  1. Not having the form notarized or failing to sign the document, both of which are required for the request to be processed.
  2. Incorrectly filling out personal details such as the driver license number or social security number, which are crucial for identifying the record holder.
  3. Omitting contact information, including a daytime telephone number and email address, which may be used for clarification or updates concerning the request.
  4. Forgetting to specify the type of record needed, such as a driver record, clearance letter, or other document, can lead to receiving the wrong information.
  5. Overlooking the payment section by not including the correct fee or choosing an inappropriate payment method. This includes forgetting to calculate the convenience fee for credit or debit card transactions.
  6. Not indicating the desired delivery method or incorrectly filling out the alternate delivery information, which can result in the records being sent to the wrong place or by an undesired method.
  7. Failure to provide accurate mailing and fax information for requests intended to be sent to an agency or third party, thus risking privacy breaches or misdelivery.

By paying close attention to these details, individuals can ensure their Form 4681 is completed accurately, helping to avoid common pitfalls that may obstruct the process of obtaining necessary records.

Documents used along the form

When dealing with driver license records or related matters in Missouri, utilizing the Form 4681 is a common practice. This form, essential for requesting driver license records, often requires additional documentation to support or expand the request. Understanding these supplementary forms and documents can streamline the process and ensure that all necessary information and approvals are in place for a smooth transaction with the Missouri Department of Revenue.

  • Form DOR-108: Application for Missouri Title and License. Used for titling and licensing vehicles, it must accompany requests related to driving records when seeking clearance for vehicle registration or title changes.
  • Form 5439: Highway Patrol Examination. Required when the record request involves verification of a vehicle inspection as part of titling or when specific queries about driving records necessitate clearance from law enforcement.
  • Form 768: General Affidavit. Utilized to provide supplemental statements or clarifications that may be necessary when discrepancies arise in the driving record or when additional verification is needed for certain details within the record.
  • Form 4601: Notice of Lien, Lien Release, or Authorization to Add/Remove Name from Title. Necessary when changes to lien information on a vehicle that is associated with the driver's record are requested, affecting title and registration.
  • Form 426: Inspection and Maintenance Program Exemption Request. Essential for drivers who need to document a request for exemption from emissions testing in their driving record, particularly for registration renewal purposes.
  • Form 1716: Permission for Driver Examination. Required for individuals under 18 seeking to have their driving test scores and permits released or for those needing official documentation of driving test results as part of their record request.
  • Form 5086: Property Tax Exemption Request. When submitting a request that pertains to vehicle registration, this form is necessary for those seeking to prove eligibility for property tax exemption as part of their driving record.
  • Form 5049: Notice of Sale or Transfer. Utilized when the record request involves changes in vehicle ownership that need to be reflected in the driving record for accurate titling and registration information.
  • Form 5429: Odometer Disclosure Statement. Required for all requests that involve vehicle sales or title changes, ensuring that accurate mileage is recorded in the driving record and associated vehicle history.

For individuals and organizations navigating the complexities of Missouri's driving record requests, understanding these forms can be crucial. They each serve an important role in ensuring accurate, legal, and timely processing of requests pertaining to driving records, vehicle registration, titling, and more. Having the correct forms prepared alongside Form 4681 can significantly expedite the process and help avoid delays or issues with the Missouri Department of Revenue.

Similar forms

The Missouri 4681 form is similar to other state and federal forms that require the release of personal information, yet it uniquely focuses on driver's license records. These documents often share commonalities such as the need for the record holder's explicit consent, a notarization process to verify the signature, and options on how the information can be received. However, the specific type of information requested and the intended use of these forms can vary significantly.

Comparable documents include:

  • The Federal Form SSA-89 (Authorization for the Social Security Administration to Release Social Security Number (SSN) Verification): Similar to Missouri's Form 468 on the aspect of releasing personal information, Federal Form SSA-89 is specifically designed to verify an individual's Social Security number for purposes such as opening a new bank account or applying for a loan. Both forms require the individual's authorization and share the need for notarization, highlighting the stringent measures in place to protect sensitive information. The main difference lies in the scope of information released—while the SSA-89 focuses on SSN verification, Form 468 encompasses a broader range of driver license records.
  • The California DMV Form INF 1125 (Request for Own Driver License or Vehicle Registration Record): This form, similar to Missouri's Form 4681, allows individuals to request their own driving or vehicle registration records. Both forms necessitate the individual's consent and include options for receiving the information through mail, fax, or email. The requirement for the record holder's signature—potentially notarized, depending on the nature of the request—underscores the importance of privacy and security in handling personal information. The parallel here lies in the functionality of allowing individuals to access their records while ensuring the process adheres to privacy regulations.

Each document, while serving a distinct purpose, underscores the critical nature of consent and security in the process of releasing personal information. Whether for verifying a Social Security number or obtaining driving records, the emphasis on authorization, notarization, and secure delivery methods reflects a shared commitment to protecting individual privacy across various contexts.

Dos and Don'ts

When dealing with the Missouri 4681 form, a critical document required for the release of driver license records, it's important to approach the process with careful attention to detail and a clear understanding of the required steps. To ensure the request is processed efficiently and accurately, here is a list of things you should and shouldn't do:

  • Do carefully read all the instructions provided in the form before filling it out, to avoid any mistakes or omissions that might delay processing.
  • Do verify that all personal information entered, such as name, address, date of birth, and Missouri driver license or social security number, matches the information in your official records.
  • Do sign and notarize the form as required, since a request will be denied if this crucial step is overlooked.
  • Do indicate clearly if you would like the requested records to be sent to an address other than the one listed by selecting the appropriate option and providing the necessary details.
  • Do choose the correct payment method and ensure that all payment information, including card details if paying by credit or debit card, is accurate to prevent delays.
  • Don't overlook the option to request records online through the official website, as this might be a faster and more convenient option for obtaining non-restricted Missouri driver record information.
  • Don't send incomplete forms, as any missing information can lead to the request being denied or delayed.
  • Don't forget to include the appropriate fee for the records you are requesting, as outlined in the payment options section of the form. Remember to account for any additional fees, such as the convenience fee for credit or debit card transactions or the fax fee if applicable.
  • Don't use information that is outdated or no longer accurate, as this can lead to issues verifying your identity and fulfilling your request.

By adhering to these guidelines, individuals can streamline the process of obtaining necessary records through the Missouri 4681 form, ensuring that all interactions with the Missouri Department of Revenue are as smooth and efficient as possible.

Misconceptions

Understanding the Missouri Form 4681 can sometimes be a bit tricky due to prevalent misconceptions. Here’s a clarification of some common misunderstandings:

  • Misconception 1: Form 4681 can only be used to request a copy of your driving record. While it’s true the form is often used for obtaining driver records, it also facilitates the request for other documents, like clearance letters or an image portfolio, encompassing personal information safeguarded by the Department of Revenue.

  • Misconception 2: Anyone can request your driving records using Form 4681 without your consent. In reality, the form explicitly requires the record holder’s approval, demonstrated through a signature and a notary verification, to release any records. This measure is in place to protect personal information from unauthorized access.

  • Misconception 3: The form must be mailed in for processing; electronic submissions are not allowed. This is incorrect, as records can indeed be requested via walk-in, mail-in, or e-mail. The form accommodates various modern convenience needs, including the option to receive records by fax or e-mail, highlighting a flexible approach to accessing personal records.

  • Misconception 4: There is only one way to pay for record requests made with Form 4681. Contrary to this belief, the form outlines multiple payment options, including cash, check, money order, and several types of credit cards, thus ensuring the process is accommodating to the payer’s preferences.

  • Misconception 5: Personal information is limited to just the individual’s driving history. This is not the case, as the form details that personal information can include a wide array of details such as name, address, date of birth, and even the individual’s photograph, among other identifiers. The distinction between personal and non-personal information highlights the breadth of data considered private and protected.

Clearing up these misconceptions helps in understanding the privileges and rights associated with Form 4681, ensuring that requests for personal records are handled with the appropriate level of consent and security.

Key takeaways

Filling out the Missouri 4681 form accurately is crucial for those needing to request their driver license records or documents that contain personal information. Here are five key takeaways to remember when completing and using this form:

  • Notarization is Mandatory: The form must be completed, signed, and notarized. If these steps are not properly followed, the request for records will be denied. Notarization ensures the authenticity of the signer's identity, adding an extra layer of security to the process.
  • Multiple Record Types Available: Applicants can request various types of records, including driver license records, clearance letters, image portfolios (black and white photos), and temporary driving privileges. Specific needs dictate the type of record requested, and there is no fee required for clearance letters or temporary driving privileges.
  • Alternative Delivery Options: The form allows records to be sent to an address different from the record holder's, providing flexibility. Records can be mailed, faxed (with a $0.50 per page fee), or emailed to an alternate address, when necessary.
  • Multiple Payment Options and Additional Fees: The fee for each record is $2.82, and there are various payment methods available, including money order, debit/credit card transactions, and cash (for in-person requests). Additional fees apply for credit or debit card transactions, known as convenience fees, ranging from $1.25 to 2.15% of the transaction, based on the amount.
  • Accessing Records Online: For faster and more convenient access to non-restricted Missouri driver record information, record holders can visit the official website and select Driver License Services. This option provides immediate access to records without the need to complete the form 4681 for some types of records.

It is important to fill out the form attentively and provide accurate information to ensure that the request is processed swiftly and correctly. By understanding these key takeaways, applicants can navigate the process of requesting their Missouri driver license records or personal documents with greater ease and efficiency.

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