MTIVS Account Maintenance

Court Information
Please enter the following information about the court.
Jurisdiction*
Court Name*
Court Number*
Court Address*
Street Address Address Line 2 City State ZIP Code
Number of Judges*
Information for Judge #1
Judge's Name*
First Last
Judge's Email*
Judge's Phone*
Information for Judge #2
Name
First Last
Judge's Email
Judge's Phone
Information for Judge #3
Name
First Last
Judge's Email
Judge's Phone
Information for Judge #4
Name
First Last
Judge's Email
Judge's Phone
Information for Judge #5
Name
First Last
Judge's Email
Judge's Phone
Liaison Information
This is the person who will be responsible for notifying DOJ when MTIVS access needs to change for new and departing staff. The Liaison will also be the person that DOJ/MVD will contact regarding any MTIVS-related customer concerns, updates, or other matters.
Responsible Liaison*
Which Judge?
Other Staff Member Information*
First Last
Job Title
Phone*
Email*
Authorized Users
In the list below, enter the personal information for each court staff member for whom MTIVS access is being requested.
List of Authorized Users*
First Name Last Name Email Address

First Name	Last Name	Email Address

Court Information