Motor Vehicle Records | Certificate of Acceptable Use

Kansas.gov: the Official Web site of the State of Kansas

Kansas Department of Revenue Request for Electronic Access to Vehicle Records Information Network of Kansas Certificate of Acceptable Use

indicates a required field
	Your Information
First Name:		City:
Last Name:		State:
Organization:		Zip:	(00000 or 00000-0000)
Title:		Phone:	(000-000-0000)
Address:		Email:	(example@company.com)
Address 2:

	Verification of your eligibility to receive the requested records. Please review the exceptions listed below and select the code that corresponds with your request(s).

	A. I am requesting my own record.
	B. I have written consent from the individual to whom the requested information pertains, to obtain records on their behalf.
	C. I work for or am acting on the behalf of a government agency and am requesting this information to fulfill the functions of that agency.
	D. I am requesting this information in connection with 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.
	E. I am an employee, agent or contractor of a legitimate business. I am requesting record information in order to verify the accuracy of personal information submitted by the individual in question. If the information I have is incorrect, I am requesting to obtain corrected information. This information will be used to pursue legal remedies against or recover on a debt or security interest against the individual in question.
	F. I am going to use this information in connection with a civil, criminal, administrative, or arbitral proceeding in a Federal, State, or local court or agency or before a self-regulatory body. This may include the service of process, investigation in anticipation of litigation, and the execution or enforcement of judgments and orders, or pursuant to an order of a Federal, State, or local court.
	G. I am involved in a research project to produce statistical reports. The personal information obtained will not be published, redisclosed or used to contact the individual in question.
	H. I am an agent, employee or contractor for an insurer; an insurance support organization or I am self-insured. The information requested will be used in connection with a claims investigation, antifraud activities, rating or underwriting.
	I. I am requesting record information to provide notice to owners of towed or impounded vehicles.
	J. I work for a licensed private investigative agency or a licensed security service.
	K. I am an employer or an agent or insurer working on the behalf of an employer of licensed commercial drivers. I am requesting records information in order to obtain or verify information relating to a holder of a commercial driver's license.
	L. I am requesting records of individuals who have given the state the express consent to release personal information by "opting in" their records.
	M. I will use the information requested in a manner that is specifically authorized by Kansas law and is related to the operation of a motor vehicle or public safety.

Your Information

Verification of your eligibility to receive the requested records.