Nebraska Driver Record Request Form (Application)

How to Complete an Application for Copy of Driving Record

To obtain a driving record, you must submit an Application for Copy of Driving Record to this office. The application must be completed in full and must be submitted with the appropriate $3.00 fee for each record requested.

Businesses and individuals wishing to obtain more than one driving record, and whose reason for requesting the records of individuals other than themselves meets one of the appropriate exempted uses defined in the Act, may attach a list with the required information for each record requested to an Application for Copies of MULTIPLE Driving Record* (This form may only be used for MULTIPLE driving record requests) and submit it along with the appropriate $3.00 fee for each record requested. (Note: The listing attached to the application is retained by the DMV.)

Businesses that submit frequent requests for driving records may wish to consider receiving these records electronically. Specific information regarding this method of receiving records may be obtained by contacting:

Nebraska.gov
301 South 13^th Street, Suite 301
Lincoln, NE 68508-2593
(402) 471-7810

One or more of the following methods of identification must be provided (please remember the more information you provide the better the chances of locating the record):

• Name of record holder AND Date of Birth;
  OR
• Name of record holder AND Nebraska Driver’s License Number;

All of the following must be provided:

• The specific reason for the record request. This reason MUST be one of the Exempted Uses listed on the back of the request form;
• Full name of the person requesting the record;
• Business name if applicable;
• Complete address of the person requesting the record;
• The signature of the person requesting the record:

If the request is submitted through the mail, the signature of the individual requesting the record MUST be notarized in Box 1 at the bottom of the application;

If the request is submitted in person at the DMV office, you must be prepared to produce proof of identification.

If the request is submitted by an individual on behalf of the record holder, the name, address and signature of the individual submitting the request should be used on the application. The record holder must then complete the section authorizing the individual to obtain the record. The record holder’s signature must be notarized in Box 2.

Date the request is signed.

Once the application is completed in full, it should be submitted to this office along with the appropriate fee ($3.00 per record requested). If the request is submitted by mail, please be sure to include a self-addressed stamped envelope.