1) The applicant has authorized in writing the procurement of this report.
2) The applicant has been informed in a separately written disclosure that a consumer report may be obtained for driver qualification purposes.
3) The information requested below will be used for a “permissible purpose” (i.e., information for qualification purposes) and will be used for no other purpose.
4) The information being obtained will not be used in violation of any federal or state equal opportunity law or regulation; and
5) Before making an adverse action based in whole or in part on the report, the applicant will receive a copy of the requested report and the summary of consumer rights as provided with the report by the consumer‐reporting agency.

I also hereby certify that this report request and the above applicant’s release notice meet the definition of “permissible uses” of state motor vehicle records under the provision of the Driver’s Privacy Protection Act of 1994 (Public Law 103‐322, Title XXX, Section 300002(a)).