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Michelin Raceway Road Atlanta - MVR - Driver's License Form

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.

PLEASE TYPE:

Your name as it appears on your driver’s license

Date of Birth:

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.

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Your legal name

Your email address

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Timestamp

Audit

April 3, 2022 8:19 pm CDT

Michelin Raceway Road Atlanta - MVR - Driver's License Form Uploaded by Connie Boring - cboring@kansasspeedway.com IP 73.185.229.245

April 3, 2022 8:25 pm CDT

Adam Ellis - aellis@roadatlanta.com added by Connie Boring - cboring@kansasspeedway.com as a CC'd Recipient Ip: 162.238.219.222

March 6, 2023 1:41 pm CDT

Stephen Timms - stimms@nascar.com added by Connie Boring - cboring@kansasspeedway.com as a CC'd Recipient Ip: 73.185.229.245

March 6, 2023 1:51 pm CDT

Stephen Timms - stimms@nascar.com added by Connie Boring - cboring@kansasspeedway.com as a CC'd Recipient Ip: 73.185.229.245