NEBRASKA DEPARTMENT OF MOTOR VEHICLES
MOTOR VEHICLE FRAUD UNIT
301 Centennial Mall, South
PO Box 94789
Lincoln, NE 68509-4789
Telephone 402) 471-3790 or (402) 471-3832
Fax (402) 471-3190

Facial Recognition Request Application
LAW ENFORCEMENT USE ONLY

A facial recognition comparison request can be made for a case being investigated and/or prosecuted in a
criminal manner. The results provided by the Nebraska Department of Motor Vehicles are to assist in furthering
an ongoing investigation or criminal matter and cannot be used as the sole reason for arrest. No officer,
employee, agent or contractor of the Department of Motor Vehicles or law enforcement officer will release a
digital image or a digital signature except to a federal, state, local law enforcement agency, a certified law
enforcement officer employed in an investigative position by a state or federal agency, or a driver licensing
agency of another state for the purpose of carrying out the functions of the agency upon the verification of the
identity of the person requesting the release of the information and the verification of the purpose of the
requester in requesting the release. Any requester that knowingly discloses or permits disclosure of a digital
image or digital signature will be guilty of a Class I misdemeanor and will be, at the discretion of the appropriate
official, removed from office or discharged. (Nebraska Revised Statutes § 60-484.02)

The images you provide are compared to Nebraska Department of Motor Vehicle images only.
Requesting Agency: ------------------------------Case Number: ---------------------------------Investigator Name/Badge Number: _________________________

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Crime Classification: ------------------------------E-mail Address/Fax Number results shall be sent to: __________________

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Brief Summary of Investigation:

Under penalty of law, the undersigned certifies that the information requested will be used as authorized by the Uniform Motor Vehicle
Records Disclosure Act. The undersigned hereby acknowledges that this request is made with the understanding that any person
requesting disclosure of sensitive personal Information from the Department of Motor Vehicles who misrepresents his or her identity,
misrepresents the purpose for which the information requested will be used, or otherwise makes a false statement on the application shall
be guilty of a class I misdemeanor.

Signature: _______________________
Nebraska DMV

Date: _________
103417

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GULaw Privacy FR