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MVR Information

DePauw University requires all persons that may operate a DPU vehicle or rental vehicle provide DPU with authorization to obtain a Motor Vehicle Report.

 

Date:

 

DePauwUniversity

Attention:  Richard Shuck 

 

Dear Mr. Shuck:

I am aware that motor vehicle reports (MVRs) may be required by DePauw University for evaluation of my eligibility to drive any vehicle rented or owned by the University.  I understand that until such report is provided to the University that I will remain ineligible. 

By signing this letter, I hereby agree to provide DePauw University such information and reports, as well as additional reports about me from time-to-time as deemed appropriate, to evaluate my insurability or for other permissible purposes.

The undersigned individual certifies he/she has not had more than (1) moving violation in the past three years, or any major traffic violations.

 

Sincerely,

 

_________________________________

Signature

 

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Name as it appears on Driver License

 

 

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Driver License Number/State of Issuance

 

 

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Date of Birth

 

 

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SSN