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Georgia Department Of Motor Vehicle Safety
Bulk Requestor Certification
__________________________________________ certifies
that its bulk user clients on whose behalf it is requesting MVR’s represents
the named company that they have received and maintained in their records
properly executed and authorizations.
A bulk requestor must only supply the MVR to the user who has
obtained the authorization but may keep a copy of its records only for the
purposes of complying with the Fair Credit Reporting Act.
Any violation of the rules of
applying for certification required by the Department of Motor Vehicle Safety or
provisions of the Fair Credit Reporting Act, or any other applicable state or
federal law will be sufficient grounds for the Department to refuse to issue any
additional information on any other driver
that the company may request. This administrative action by the Department
will not be deemed to supersede any other sanctions prescribed by law,
including, but not limited to, 1975 Ga. Laws,
pp. 1021, 1022 (section 215 © of Georgia Code Title 68B), providing
for twelve (12) months in prison or a fine of $1,000.00 or both for violating
rules and regulations concerning motor vehicle
reports.
The Department of Motor Vehicle Safety has the right to check
all records, files, reports, or any other
materials deemed necessary to verify that the company filing this certificate
has not violated any provisions of the
Department of Motor Vehicle Safety, or provision of the Fair Credit
Reporting Act, or any other applicable state or federal law, for the purpose of
verifying information contained in this certificate.
The burden of showing compliance with the provisions of this
certificate is at all times on the company filing this certificate. Upon
reasonable notice by the Department the company must be able
to demonstrate such compliance.
Dated at ______________this___________day of _________________,
20_____
Applicant___________________________________
Address_____________________________________
Telephone Number____________________________
Signature Person Authorized to Sign
Contract_____________________________
Title___________________________________________
Authority: GA. L. 1975, pp. 1008, 1021 (Ga. Code Ann. Section
68-B-215
DMVS Rule 570-3.15.
Print and Fax to 229-420-0805
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