Get Form 4170 - Certified Driver Record Request - Missouri Department ...

Filling out the Form 4170 is an essential step for individuals seeking to request their certified driver records from the Missouri Department of Revenue. This guide will provide you with a clear and concise pathway to complete the form accurately and efficiently online.

Follow the steps to fill out the form online effectively.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the requester information. Fill in your name, address, city, state, zip code, telephone number, fax number, and email address in the appropriate fields.
3. Provide the driver information. Include your full name (last, first, and middle initial), social security number, driver license number, and date of birth in the specified format (MM/DD/YYYY).
4. Indicate the documents you wish to receive by checking the appropriate boxes. Choose among options such as a certified copy of your driving record or records related to suspensions.
5. If you are requesting information on specific cases, provide the necessary case numbers, and the relevant dates as specified on the form.
6. Affirm the accuracy of your information by signing and dating the form in the designated signature section.
7. After completing the form, you can save changes, download, print, or share the document for submission.

Complete your Form 4170 online today to ensure your request is processed efficiently.