DMV Form

DMV

Costs:

SEARCH $50.00

RUSH $15.00

DISBURSEMENT TO DEPT. $10 per doc $10.00

ADMINISTRATIVE HANDLING $5.00

Subtotal

ADDITIONS?

YOUR TIME FRAME

Your information:

FILL IN THE APPROPRIATE INFORMATION FOR CONDUCTING SEARCH:

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Please indicate search(es) requested by checking the appropriate box(ES)


Your Instruction to Us for Handling



**** PLEASE NOTE FEES WILL BE CHARGED WHETHER THE REQUESTED INFORMATION IS AVAILABLE OR NOT



Please Note: With respect to the above referenced information obtained from the records of the New York State Department of Motor Vehicles, and to the extent that the said information contains personal information as defined by §§2725(3) of the FEDERAL DRIVER'S PRIVACY PROTECTION ACT, 18 U.S.C. Section 272 et seq., SERVICO, INC. Hereby conveys said Information to the REQUESTER pursuant to the express or Implied representation and warranty of REQUESTER that REQUESTER has requested said information and accepts same on the condition that said information will not be used for any purpose expressively permitted by the said FEDERAL DRIVER'S PRIVACY PROTECT ACT. By accepting the said information, REQUESTER agrees to indemnify and hold harmless SERVICO, INC. from any and all claims and liabilities of whatsoever nature that may be made against SERVICO, INC., and to pay all expenses, including reasonable costs and attorney fees, that may be Incurred by SERVICO, INC., as a result of or arising out of or in any way connected with the misuse of or unlawful disclosure of the information provided to REQUESTER.

contact information:

Billing information:

SEARCH $55.00

RUSH $15.00

DISBURSEMENT TO DEPT. $10 per doc $10.00

ADMINISTRATIVE HANDLING $5.00

Subtotal


This fee is an estimate only. It is possible to incur additional disbursements in completing this order. All additional fees will be charged to this credit card. By reading this, you agree to the terms and conditions, and verify that all the information submitted here is correct. By clicking 'Checkout' you acknowledge this statement.

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