License Event Notification Consent Form
The status and validity of a driver’s license must be verified in order to operate a State owned/leased/rented vehicle. The New York State Department of Motor Vehicles has such a program called LENS (License Event Notification Service). By completing this form below, you will be giving the University permission to seek this verification.
I,_____________________________________________________, hereby authorize the University to verify my driver’s license information. This is a Department of Motor Vehicle record check to determine my eligibility to drive a New York State owned, leased or rented vehicle. I also certify that I do not have a physical/medical condition that would impair my ability to operate a vehicle.
Email: (Required For Online Training): __________________________________
SUNY Binghamton Department and Supervisor To notify of License Check and Online Training Results: ___________________________________________________
Information from Drivers License:
Driver's License ID#:_______________
Driver’s License State:______________
Name: Last, Middle, First ____________,____________,____________
Date of Birth:_____/_____/______
Check where appropriate: Female:__ Male:__
Upon completion, please seal in an envelope and forward to Ken Waskie, Director of Purchasing, McGuire Building.