Chicagoland - MVR - Drivers License Form
DRIVER’S LICENSE INFORMATION
This information is mandatory for any individual driving any vehicle owned/operated/rented by NASCAR. There are no exceptions. This information must be provided in advance so that license checks may be requested and driving record information received by our insurance carrier prior to use of any of the vehicles.
Your name as it appears on your driver’s license
Date of birth
Driving FrequencyDailyRace Time OnlyOccasional Only
NOTICE TO THE FAIR CREDIT REPORTING ACT
It has been made clear and conspicuous to the undersigned that a motor vehicle report is being requested.
The undersigned gives written permission to obtain a motor vehicle report, which will be used for purpose of insurance, employment, or other legitimate business purposes permissible under the Fair Credit Reporting Act and for no other purpose.
Should driving privileges be denied, before any adverse action is taken based on the motor vehicle report, the undersigned will have the opportunity to appeal the denial by producing a copy of their motor vehicle report to the Risk Manager to be reconsidered.
Leave this empty:
Your legal name
Your email address
If you have questions about the contents of this document, you can email the document owner.
Document Name: Chicagoland - MVR - Drivers License Form
Agree & Sign