Form Tc-890 - Release Of Protected Motor Vehicle Information
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1Utah State Tax Commission
TC-890
Release of Protected Motor Vehicle Information
Rev.9/97
Requester's name
Requested vehicle record
(plate number or VIN) or owner's name
Company
Requester's address (
this release is
NOT COMPLETE
without street, city, and ZIP
)
See Attached List.
Justification Statement (this document must be signed below)
Check one of the boxes that describes why you are entitled to receive protected motor vehicle information as outlined in the
Utah Code Section 41-1a-116(4) or the Federal Driver’ s Privacy Protection Act, Public Law 103-322.
The person making the request is the name on record, or in the case of an incorporated business, an officer of the corporation.
Government agency, including any court or law enforcement agency, to carry out its function.
For use by a legitimate business, in the normal course of business, to verify the accuracy of personal information submitted by the
individual.
For use by any federal, state, or local court or agency connected with a civil, criminal, administrative, or arbitral proceeding.
For use by any insurer or insurance support organization, or by a self-insured for entity claims investigation activities.
For use to provide notice to owners of towed or impounded vehicles.
Tower, in accordance with Utah Code Section 41-6-191
Business license no.: ___________________, location _____________________
Mechanic, in accordance with Utah Code Section 38-2-4
Business license no.: ___________________, location _____________________
For use by any licensed private investigative agency or licensed security service for purposed provide by law.
Private investigator License number: ____________________
Expiration date: ____________________
For use by any requester with a NOTARIZED, written consent from the individual who is the name on record.
Other (please explain)
* The Tax Commission reserves the right to notify the individual about whom protected information is requested.
Requester's Signature and Employees Authorized to Receive Protected Records
As the requester of this information and the signer of this form, I assume all responsibility for the protected motor vehicle record(s) I am
requesting as outlined in Utah Code Section 41-1a-116(4)(a) and 53-9-118 & 119, and the Federal Driver's Privacy Protection Act, Public
Law 103-322 (see back of form). I understand that protected motor vehicle information may not be disclosed to any other person or used
for advertising or solicitation purposes.
Requester's signature
Date signed
X
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