British ColumbiaQuebecManitobaNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutPrince Edward IslandSaskatchewanYukon

Provincial regulations prevent us from requesting driving records inmany different provinces. Please select below the province or terri-tory from which your driver's license is issued to retrieve your form.

Canada Driver’s License Submission Instructions

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Only fill out the highlighted section of your form.

Once you have filled out your Driver's AbstractRequest, email it to DLcheck@maven.com tocomplete the registration process to join Maven.Do not submit this form on your own behalf.

(Please note it could take up to three weeks for your license to be processed.)

Date of Birth: Driver’s Licence Number:

Return abstract by:

Mail

Fax FAX NUMBER

Email EMAIL ADDRESS

SIGNATURE OF DRIVER

MV2680 (062005)

STREET / PO BOX / RR#

NAME OF COMPANY

MAILING ADDRESS

CITY / PROVINCE / STATE POSTAL CODE / ZIP CODE

COMPANY NUMBER 5

Companies with access to driver abstract must be listed below before driver signs

COMPANY NUMBER 6

COMPANY NUMBER 7

COMPANY NUMBER 8

COMPANY NUMBER 1

COMPANY NUMBER 2

COMPANY NUMBER 3

COMPANY NUMBER 4

Driver information

LAST FIRST MIDDLE

STREET / PO BOX / RR # CITY/PROVINCE /STATE POSTAL CODE /ZIP CODE

Search fee enclosed $ OR Search fee account no:

I authorize the above named company to obtain a copy of my driver’s abstract from the Insurance Corporation of British Columbia.

Name of Driver:

Address:

Please type or print clearly, illegible information cannot be processed.

If you wish to charge the Search Fee to Visa, MasterCard or American Express, please include the information below:NAME AS IT APPEARS ON CREDIT CARD CREDIT CARD NUMBER EXPIRY DATE

Driver’s Licence Abstract Request

(ddmmmyyyy)

DATE OF REQUEST

Licensing Support ServicesPO Box 3750Victoria, British ColumbiaV8W 3Y5

Telephone 250-414-7732Fax 250-978-8012

✔ support@imvrs.com

Datalink Services, Inc dba Compass Driving Records

PO Box 163355

Sacramento,CA 95816

Datalink Services, Inc dba Compass Driving Records

DRIVER’S LICENCE HOLDERLast name

Date of birthOffice Extension

AUTHORIZATION OF THE LICENCE HOLDER

Comments

Last address in Québec

French

Québec driver’s licence number Telephone

SignatureDate (Year-Month-Day)

Protection of Personal Information

All personal information gathered by authorized Société de l’assurance automobile du Québec (SAAQ) personnel is handled confidentially. The SAAQ requires this information to apply the Automobile Insurance Act, the Act respecting the Société de l’assurance automobile du Québec and the Highway Safety Code. Under the Act respecting Access to documents held by public bodies and the Protection of personal information, this information may be conveyed to the SAAQ’s licensing agents and other Government departments or agencies, or used for statistical, survey, study, audit or investigative purposes. Failure to provide this information can result in a refusal of service. You may consult, correct or obtain a copy of any personal information concerning you.

For more information, consult the Policy on Privacy on the SAAQ’s website at saaq.gouv.qc.ca or contact the SAAQ’s call centre.

Note: The driver’s abstract will be sent to only one addressee and by only one means of delivery.

Mail to the following address (outside Québec only):

Fax to the following number (outside Québec only):

or

By fax: 418 644-7167

Division de la diffusion (act. 850)Société de l’assurance automobile du Québec333, boulevard Jean-LesageCase postale 19600, succursale TerminusQuébec (Québec) G1K 8J6

By mail:Send or

Home

First name

Year Month Day

Driver’s abstract prepared in

English

I authorize the Société de l’assurance automobile du Québec to send me my driver’s abstract.

Street number Street name Apartment

Municipality

Province or State Country Postal code

Country code Local or area code Fax number

Application for the Driver’s Abstract of a Person Residing or Temporarily Living Outside Québec

Notice to readers: This document complies with Québec government standard S G Q R I 0 0 8 - 0 2 on the accessibility of downloadable documents. If you experience difficulties, please contact us at: 1 800 3 6 1 – 7 6 2 0.

Société de l’assurance automobile du Québec

7147A 30 (2016-11)

Canada General Release and Authorization

Datalink Services, Inc

PO Box 163355

Sacramento, CA 95816

Phone: 866.454.3238 Fax: 866.790.5246

Client Information:

Company Name: ____________________________________ Account #: _____________

Contact Name: _____________________________________ Phone #: _______________

Purpose of use: Insurance Employment

Applicant/Subject Information:

(PRINT CLEARLY)

Name (First, MI, Last): ________________________________________________________

Date of Birth (mm/dd/yyyy): ______________-___________-___________

Driver’s License Number: _____________________________________________________

Province: __________________________________

I do hereby authorize and allow Datalink Services, Inc to obtain a copy of my driver abstract information,

which will be used for the above stated purpose. I authorize, without reservation, any party or agency

contacted to furnish the above mentioned information and release all parties involved from any liability

and/or responsibility for doing so. I understand that this authorization and consent shall be valid in an

original, fax or copy form.

Driver’s Signature: _______________________________ Date: ______________

Requested by

Request forDriver/Vehicle Information

Name

Driver AbstractDriver’s Licence Number or Date of Birth

Name

Name

Name

Name

For Third Party Requests Only

I, , of Name Company Name (if applicable)

certify that I have obtained prior written consent from the above named, to obtain a copy of their driver abstracts for the purposeindicated above.

OR

Vehicle Search

Vehicle Owner History

Plate # and/or

VIN:

For Office Use Only

Fee Paid Authorized By Clerk

Send cheque or money order made payable to Newfoundland Exchequer Account or Visa Mastercard

Expiry Date

P. O. Box 5127-9 Roddick Crescent

Harbour Grace, NL A0A 2M0Fax: 709-945-3114

8 Myer’s Avenue, Suite 201P. O. Box 1148

Clarenville, NL A0E 1J0Fax: 709-466-4070

230 Airport Blvd., Fraser MallP. O. Box 2222, Gander NL A1V 9N9

Fax: 709-256-1438

Sir Richard Squires Building,84 Mount Bernard AvenueCorner Brook, NL A2H 6B9

Fax: 709-637-2615

Bruno Plaza, 118 Humphrey RoadLabrador City, NL A2V 2J8

Fax: 709-944-5630

Mailing Address: P. O. Box 8710

St. John’s, NL A1B 4J5 Office Location: 149 Smallwood Drive, Mount Pearl

Fax: 709-729-7616

Service NL

PRIVACY NOTICEUnder the Authority of the Highway Traffic Act (HTA), personal information will be collected for the purpose of issuing a Newfoundland and Labrador Driver’s Abstract.Section 6 of the HTA allows Motor Registration Division to disclose an applicant’s personal information to law enforcement and/or select federal, provincial andmunicipal officials. Any questions relating to this privacy statement can be directed to the Motor Registration Division toll-free at 1-877-636-6867.

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Payment Information

D DM MY Y Y Y

DateApplicant’s Signature Driver Licence Number

For prompt processing, please return completed form to the Motor Registration Division office nearest your location:

M MY Y Y Y

Applicant’s Signature Card Number

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3

02 0

2 9

50 0

01b_2

015 0

6

Customer Fax # or Email Address

Reason for Request (Please Check)

Employment Insurance Other (please specify)

Driver’s Licence Number or Date of Birth

Driver’s Licence Number or Date of Birth

Driver’s Licence Number or Date of Birth

Driver’s Licence Number or Date of Birth

Incomplete information may result in a delay in processing. To avoid delays, ensure all sections are completed correctly.

Toll-free inquiries please call 1-877-636-6871 or our web site at www.servicenl.gov.nl.ca

Provincial Building, 3 Cromer AvenueGrand Falls-Windsor, NL A2A 1W9

Fax: 709-292-4387

P. O. Box 3014, Stn. B2 Tenth Street

Happy Valley-Goose Bay, NLA0B 1B0

Fax: 709-896-4340

Mark Haddy Datalink Services, Inc.

Driver Abstract Request Form DRIVER INFORMATION AUTHORIZATION TO DISCLOSE DRIVER ABSTRACT EMPLOYEE AUTHORIZATION

DRIVER’S SIGNATURE* ________________________________________________ DATE ________________________ *A photocopy of this signed authorization shall have the same authority as the original. PAYOR INFORMATION – IF DIFFERENT FROM ABOVE DRIVER IF REQUESTED VIA MAIL (TO ADDRESS BELOW) OR FAX (TO FAX BELOW) PLEASE SEND $10.00 PAYMENT PER DRIVER ABSTRACT BY CHEQUE OR MONEY ORDER, PAYABLE TO MANITOBA PUBLIC INSURANCE OR PROVIDE THE FOLLOWING CREDIT CARD INFORMATION .

Mail/Fax Request To:

Manitoba Public Insurance Driver Records and Suspensions Box 6300 Winnipeg, MB R3C 4A4 Fax: 204-954-5357

OFFICE USE ONLY:

Fee Paid

$10

FOR MORE INFORMATION CALL: 204-985-0980 or TOLL FREE: 1-866-323-0543 REV (04/15)

Name: ___________________________________________________________________________________________ Last Name First Name Middle Initial

Driver’s Licence Number: ____________________________________ Date of Birth: ________/_________/__________ Month Day Year

Telephone Number: ______________________________ Return Fax No. or Address: ___________________________ Type of Abstract Requested: Driver Abstract

Commercial Driver Abstract

I hereby authorize Manitoba Public Insurance, to disclose my Driver Abstract to the individual/company noted below, in person, by facsimile or by mail. Individual/Company: ________________________________________________________________________________ Address: _______________________________________________ Fax Number: _______________________________

I hereby authorize Manitoba Public Insurance to disclose my Driver Abstract to _________________________________________________________________________________________________ Employer

for the duration of my employment with said employer or until such time that I advise Manitoba Public Insurance, in writing, to revoke this authorization.

Address: _______________________________________________ Fax Number: _______________________________

Individual / Company Name: ____________________________________________________________________________

Company Contact Name: ______________________________________________________________________________

Contact Phone Number: _________________________ Contact Fax Number: ___________________________________

VISA / MasterCard Number: __________________________________________________________________________

Card Expiry Date: _________________Card Holder Signature: ______________________________________________

DRIVER ABSTRACT REQUEST I, __________________________________________________________ of _______________________________________________________________________, Full Name Full Address

declare that my Driver’s Licence Number is: _________________ . My Date of Birth is:___________________________________________. Month, Day, Year

WAIVER I, ___________________________________________________________, hereby authorize Road Licensing and Safety Division and/or it’s Client Name

Issuing Agent to release my Driver Abstract and all the information contained therein to _________________________________. Reciever Name

PAYMENT Please charge fee of $19.00 to the following credit card: _________________________________________________________ ____________________ Card Holder Name Type of Card ____________________________________________________________________________________________ _________________________________ Card Number Expiry Date

CONTACT INFORMATION My contact information is: Phone:________________________________________________ Fax:___________________________________________________ E-Mail: _______________________________________________ ________________________________________________________ _____________________________________ Client Signature Date Please send requests to: Driver & Vehicle Licensing – Yellowknife Office

5015-49th Street, 1st Floor, NGB Box 1320, Yellowknife NT X1A 2L9 Phone: 867-873-7487 Fax: 867-669-9094

Driver Abstract Request(for Out of Province use only)

NOTE: Please fax completed form to: (902) 424-0602. All requests will be processed within three business days andin the order in which they are received. If all requested information is not provided, your Driver Abstract request willnot be processed. For further information you may contact us at ( 902 ) 424-5851 or 1-800-898-7668.

Client Information

Client Name: Date of Birth: / / Day / M onth / Year

Master Number: Daytime Phone#: ( ) -

Client Signature: Date:

Reason Driver Abstract is required: (For more information on abstract types visit: http://novascotia.ca/snsmr/rmv/licence/abstracts.asp )

�Employment �Insurance �Other Motor Vehicle Department �Client / Taxi Licence

To forward your abstract to an insurance company or employer on your behalf we require either:

Contact Name: Or Policy / Ref Number:

Please check manner to receive Driver Abstract:

� By Fax to: ( ) - ( include area code)

� By Mail to: Name:

Street:

City/Town:

Province: Postal Code:

Terms of Credit Card Use: By signing this form, I authorize Access NS / RMV to use the credit carddetails below to process payment for the attached batch of transactions. Access NS / RMV will destroy the creditcard information after this batch of transactions is processed and will not use for any other purpose.

Credit Card Holder Signature: Date:

(Cut and shred this section after processing)

Credit Card Payment Details

9 Visa (16 digits) 9 MasterCard (16 digits) 9 American Express (15 digits)

Account Number: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ Expiry Date: __ __ / __ __ M M / Y Y

Card Holder Name: (Please Print Clearly)

ᐱᕙᓪᓕᐊᔪᓕᕆᔨᒃᑯᑦ ᐃᖏᕐᕋᔪᓕᕆᔨᒃᑯᓪᓗ

Department of Economic Development and TransportationPivalliayuliqiyikkut Ingilrayuliqiyitkullu

Ministère du Développement économique et des Transports

P. O. Box 2420 Cambridge Bay, NU XOB 0C0Phone: (867) 983-4231Fax: (867) 983-4011

P. O. Box 10 Gjoa Haven, NU XOB 1J0Phone: (867) 360-4616Fax: (867) 360-4619

P. O. Box 88 Rankin Inlet, NU X0C 0G0Phone: (867) 645-8466Fax: (867) 645-8467

P. O. Box 1000, Station 1575 Iqaluit, NU X0A 0H0Phone: (867) 975-7840Fax: (867) 975-7820

REQUEST FORM FORDRIVER’S ABSTRACTS, SEARCHES AND ACCIDENT REPORTS

Please indicate which information you are requesting; if you are not picking up or arranging for delivery of the form to yourself, please submit a separate signed letter authorizing the release of the information that you are requesting.

Date of Request Signature

DRIVER’S ABSTRACT ($12.60 FEE)Name (first, last)

Date of birth (dd/mm/yyyy)

Driver’s Licence Number (requires 6-digit Nunavut driver’s license number)

SEARCHES ($12.10 FEE)License Plate NumberValidation Tag NumberVehicle Identification NumberOther

ACCIDENT REPORTS ($12.10 FEE)File NumberDate of Accident (dd/mm/yyyy)

Parties Involved

Validation Tag Number

AUTHORIZATION TO RELEASE OF INFORMATIONSend report to myself Yes NoI hereby authorize the Motor Vehicles Division to send this report to:NameMailing AddressEmail Address

TO BE FILLED OUT BY MOTOR VEHICLES OR AGENTRequested byDate (dd/mm/yyyy)Company nameInterim Receipt # AmountIssued bySignature (of Issuer)

ᐱᕙᓪᓕᐊᔪᓕᕆᔨᒃᑯᑦ ᐃᖏᕐᕋᔪᓕᕆᔨᒃᑯᓪᓗ

Department of Economic Development and TransportationPivalliayuliqiyikkut Ingilrayuliqiyitkullu

Ministère du Développement économique et des Transports

P. O. Box 2420 Cambridge Bay, NU XOB 0C0Phone: (867) 983-4231Fax: (867) 983-4011

P. O. Box 10 Gjoa Haven, NU XOB 1J0Phone: (867) 360-4616Fax: (867) 360-4619

P. O. Box 88 Rankin Inlet, NU X0C 0G0Phone: (867) 645-8466Fax: (867) 645-8467

P. O. Box 1000, Station 1575 Iqaluit, NU X0A 0H0Phone: (867) 975-7840Fax: (867) 975-7820

REMITTANCE SLIPPlease indicate method of payment for the attached invoices:

VISA MasterCard AMEX (not available in Rankin Inlet)

Total Remittance: ___________________

_____________________________________________________Card Holder Name

______________________________________ ______________Credit Card Number Expiry Date

_____________________________________________________Signature

Department of Transportation, Infrastructure and Energy Highway Safety Division

PO Box 2000Charlottetown, PEI C1A 7N8

Request for Driver`s Abstract

Please note: cost for each abstract is $25.00.

If you require a driver`s abstract, for employment or insurance purposes, please check the

appropriate box(s): 9 Employment 9 Insurance

I require confirmation of Driving Experience 9In order for us to process this request we require the following information:

Full name (as it appears on the driver’s licence) ____________________________________Date of birth: ____________________ Telephone number : (______)___________________PEI Driver’s Licence number: __________________________________________________Last two PEI addresses (if applicable) :_____________________________________ _________________________________________________________________________ _________________________________________________________________________ ____________________________________

Please indicate: MASTERCARD 9 OR VISA 9

Credit Card number ______________________________ Credit Card expiry date: Cardholder signature : _____________________________________________________

***NOTE: Only VISA and MASTERCARD CREDIT CARDS accepted DEBIT/CREDIT CARD IS NOT ACCEPTED

Mail to: last known PEI address on the OR: Fax only to: Applicant submitting requestrecords of this Department: Employer, Insurance Co., Motor Vehicle ____________________________________ or Government Dept. ____________________________________ Fax: (_____)____________________ ____________________________________

OR: May be picked up by the person designated below, upon presentation of appropriate

identification.______________________________________________________________________________

Signature of applicant : __________________________________________________________

The driving record abstract can only be requested by the licence holder, as it contains personal

information. A separate application must be completed and signed by each applicant.

If the credit card holder is anyone other than the licence holder, the cardholder must provide

written consent.

Please fax your request to Charlottetown at (902) 368-5236 OR Summerside (902) 432-2529

For more information please contact Records Section (902)368-5210 or (902)888-8264.

Personal Information on this form is collected under the authority of section 70 of Prince Edward Island's Highway Traffic Act and will be

used for the purpose of the issuance of a driver's license to an applicant. If you have any questions about this collection of personal

information, you may contact the Department of Transportation, Infrastructure and Energy, Registrar of Motor Vehicles, PO Box 2000,

Charlottetown, PE C1A 7N8. Telephone: (902)-368-5223.