Please make sure that all of the fields are completely filled in. THE LICENSE PLATE MUST APPEAR EXACTLY AS IT DOES ON THE VEHICLE.
 
LICENSE PLATE NUMBER - INCLUDE SPACES
NOTICE OF INTENTION TO REQUEST A REVERSE LICENSE PLATE SEARCH
PURSUANT TO s.1145.1 OF THE VEHICLE LICENSING ACT
MOTOR VEHICLE TRAFFIC OFFENCE(S)
 
Take notice that a License Plate Search will be Recorded
NAME OF INDIVIDUAL REQUESTING SEARCH (last, first)
CURRENT EMAIL ADDRESS (must be valid)
STATE / PROV OF LICENSE PLATE INFRAC NO# (police use only)
   
I wish to give notice of my intention to perform a complete license plate search for the purpose of obtaining information regarding the owner of the above noted license plate tag.
 

If you are requesting a search as an agent for the above noted individual, please complete the following:

I,
acknowledge that the person named above has authorized me to file the Notice as listed.
CURRENT MAILING ADDRESS OF AGENT
APT./SUITE CITY
STATE ZIP CODE
DAYTIME TELEPHONE NUMBER  
WHITE - OFFICE YELLOW - PROVINCE