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Fill in a Valid Missouri 4681 Template

The Missouri 4681 form is a request form that allows a driver license record holder to approve the release of their personal information. To obtain driver license records, the form must be completed, signed, and notarized; otherwise, the request will be denied. For a quick and easy way to access non-restricted Missouri driver record information, visit the state DMV website or a local license office.

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Article Guide

The Missouri 4681 form plays a crucial role in managing the release of driver license records and other personal information held by the state. Individuals seeking access to their records must complete this form, ensuring it is signed and notarized; otherwise, their request may be denied. The form requires essential personal details, such as the individual's name, address, date of birth, and driver license number. It also distinguishes between personal information—like social security numbers and photographs—and non-personal information, which may include driving history and zip codes. For those looking for a more efficient way to obtain non-restricted driver record information, options are available online through the Missouri Department of Revenue's website or at local license offices. The form outlines various payment options and provides instructions for submitting requests via mail, fax, or email. Additionally, it includes a section for notarization, ensuring that the request is verified and legitimate. Understanding the Missouri 4681 form is essential for anyone needing to access their driving records or related documents.

Missouri 4681 Preview

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
	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
Cash	Check	Order	Card	Discover	Visa	Express	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

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Dos and Don'ts

When filling out the Missouri 4681 form, it is essential to follow certain guidelines to ensure a smooth process. Here are six things you should and shouldn't do:

Do ensure that all personal information is accurate and complete.
Do sign and date the form before submission.
Do notarize the form as required; without notarization, your request will be denied.
Do specify the method of receiving the records if it differs from the record holder’s address.
Don't forget to include payment; the fee is $2.82 per record.
Don't submit the form without reviewing it for any errors or omissions.

Key takeaways

When filling out and using the Missouri 4681 form, keep these key points in mind:

Approval Required: The record holder must approve the release of their driver license records. Without their signature and notarization, your request will be denied.
Personal Information: Be aware that personal information includes sensitive details such as the individual's name, address, and social security number. Handle this information with care.
Multiple Submission Options: You can obtain records through walk-in, mail-in, or email requests. Choose the method that is most convenient for you.
Fees Apply: A fee of $2.82 per record is required. Additional convenience fees may apply for credit or debit card transactions, so plan accordingly.

Completing this form accurately and understanding its requirements can help ensure a smooth process in obtaining driver license records.

Misconceptions

Misconception 1: The Missouri 4681 form can be submitted without notarization.

In fact, the form must be signed and notarized. Without this step, the request will be denied.

Misconception 2: Anyone can request driver license records.

Only the record holder can approve the release of their personal information. This is to protect privacy.

Misconception 3: There is no fee for obtaining driver license records.

A fee of $2.82 per record is required. Additional charges may apply for convenience fees on card transactions.

Misconception 4: Records can only be obtained in person.

Records can be requested through walk-in, mail-in, or e-mail methods, providing flexibility for the requester.

Misconception 5: The form is only for personal driver records.

The form can also be used to request clearance letters or temporary driving privileges, among other options.

Misconception 6: All personal information is available without restrictions.

Only non-personal information, like driving history and zip code, may be shared without the record holder's consent.

Similar forms

The Missouri 4681 form is primarily used for requesting driver license records, but there are several other documents that serve similar purposes in various contexts. Here’s a list of nine documents that share similarities with the Missouri 4681 form:

California DMV Request for Driver Record (Form INF 1125): Like the Missouri 4681, this form requires the record holder's consent to release personal information related to their driving history.
Florida Driver License Record Request (Form HSMV 83146): This form also necessitates the signature of the record holder and can be submitted in person or by mail, similar to the process outlined in Missouri.
California Hold Harmless Agreement: This essential document helps in mitigating liabilities during events or activities by ensuring that one party is protected from lawsuits, making it vital for various scenarios; you can find more at smarttemplates.net/.
Texas Request for Driver Record (Form DR-1): In Texas, this form allows individuals to request their driving records, requiring identification and payment, mirroring the fee structure of the Missouri 4681.
New York DMV Request for Driving Record (Form MV-15): This form is used to obtain a driving record and also mandates the record holder's authorization for release, akin to the Missouri requirements.
Illinois Driver Record Request (Form VR-350): Similar to the Missouri 4681, this form requires personal information and a signature from the record holder to process the request.
Ohio BMV Driver Record Request (Form BMV 1173): This document allows individuals to obtain their driving records with the necessary consent, reflecting the same principles as the Missouri form.
Pennsylvania Request for Driver Information (Form DL-503): In Pennsylvania, this form facilitates the request for driving records, requiring the record holder's signature, similar to the Missouri process.
Virginia Driver Record Request (Form DMV 101): This form is used to request a driving record in Virginia and requires the record holder’s consent, paralleling the Missouri 4681.
Michigan Driver Record Request (Form BDVR-153): This form allows individuals to request their driving records and requires the record holder’s authorization, much like the Missouri 4681.

Each of these documents shares a common goal: to ensure that personal driving information is released only with the appropriate consent, maintaining privacy and security for individuals. Understanding these similarities can help in navigating the process of obtaining driving records across different states.