Get NC DMV TR-67 A 2021-2024

Official use only North Carolina Division of Motor Vehicles Request for Motor Vehicle Information Crash Reports Effective September 13 1997 all motor vehicle records are subject to the Federal Driver s Privacy Protection Act FDPPA and General Statute 20-43. 1. A crash report is a motor vehicle record. The FDPPA and GS 20-43. 1 require that personal information in the Division of Motor Vehicles records be closed to the public* Personal information from these records may be released to individuals or organizations that qualify under one of the fourteen exceptions listed on the back of this form* These exceptions are summarized statements of permissible uses. I hereby request a copy of a crash report for Name of Driver DL Date of Crash County of Crash I am requesting Certified Copy 5. 00 I am qualified to obtain this information for my own personal record or I qualify under exception number listed on the reverse side. My signature on this document acknowledges that I understand that improper release of information and/or false representations to gain information from DMV s records are prohibited acts. Requested by Full Name Print Date Signature Agency or Company Street Address City State Zip Code Identification provided License/ID Other ID if not License Make checks payable to NCDMV. Mail requests to Traffic Records Section Crash Reports Unit 3105 Mail Service Center Raleigh NC 27699-3105 TR-67 A revised 10/05 FEDERAL DRIVER S PRIVACY PROTECTION ACT Enacted by Congress August 24 1994 Chapter 123 Section 2721 requires that personal information Division of Motor Vehicles records be closed to the public* This refers to photos social security numbers drivers license numbers names addresses telephone numbers and medical information* General Purpose Division of motor vehicle and any officer employee or contractor therefore shall not knowingly disclose or otherwise make available to any person or entity personal information about any individual obtained by the division in connection with a motor vehicle record. Permissible Uses Personal information SHALL be disclosed for use in connection with matters of A. B. C. D. E* Motor vehicle or driver safety and theft Motor vehicle emissions Performance monitoring of motor vehicles and dealers by motor vehicle manufacturers Removal of non-owner records from the original owners if motor vehicle manufacturers to carry out purpose of the Automobile Information Act the Motor Vehicle Information and Cost Saving Act the National Traffic and Motor Safety Act of 1966 the Anti-Car Theft Act of 1992 and the Clean Air Act. Exceptions Personal information MAY be released for the following reasons List qualifying number on reverse For use by any government agency or any private person or entity acting on behalf of a Federal State or local agency in carrying out its functions. For use in matters of motor vehicle or driver safety and theft motor vehicle emissions motor vehicle product alterations recalls or advisories performance monitoring of motor vehicles motor vehicle parts and dealers motor vehicle market research activities including survey research and removal of non-owner records from the original owner records of motor vehicle manufacturers For use in the normal course of business by a legitimate business but only a* To verify accuracy of personal information b.