DMV Pull Notice Program Driver Information Form First Name Last Name Middle Name (Full Middle Name Required) Email CWID Driver's License Number *Out-of-State Drivers must submit a scanned version of their license to usftravel in order to request a DMV Motor Vehicle Record. Please allow for up to 4 weeks for processing by the DMV. Date of Birth License Expiration Date Department Information Status Student Faculty Student/Staff Staff Volunteer (Volunteer must complete a background check through Human Resources before becoming an Authorized Driver) Please note that if you are a student who is employed on any position at the University, you must select "Student" and fill out the Graduation Term box. Graduation Term (Ex. Spring/2016) Title If Faculty, include your title. Department/class you will be driving for Driver's Supervisor Reason for Driving Will you be driving a University owned vehicle? Yes No Please fill out this Key FOB Agreement Form and return to Risk Management Office Leave this field blank