DOT Certified Driving Records Request
* Denotes Required Fields
Driver/Client Information:
WI Driver License Number: - - -
* First Name:
Middle Name:
* Last Name: Name Suffix: (Jr, Sr, I, II)
* Gender:
* Birth Date:
Date of Violation:
Court Date:
Agency Information:
* Office:
Attention (Mail to):
* Requestor:
* Requestor's Phone: -      Ext
Requestor's Email:
* Note: If the requestor email address is entered - the document will arrive as an email attachment rather than through the postal service.