Dvs Records Request - Dl Record - Minnesota Department Of Public Safety
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4MINNESOTA DEPARTMENT OF PUBLIC SAFETY
Print Form
DRIVER AND VEHICLE SERVICES
Mail requests to:
445 Minnesota Street,Saint Paul, MN 55101-5161
Driver and Vehicle Services
Phone: (651) 296-2940 TTY: (651) 282-6555
Records Unit
dvs.dps.mn.gov
445 Minnesota St., Ste. 161
DV S R ECORD RE QUEST
St. Paul, MN 55101-5161
• For a driving record, complete Section A.
• For a motor vehicle record, complete Section B.
• All requestors must complete Section C.
• If mailing in: Requester must include a legible copy of driver license, government issued identification card, or notarized
signature.
A. Driving Record Request:
Minnesota DL/ID Number:
Driver's Name: Last, First, Middle
Date of Birth:
-
-
-
-
Check all that apply. For multiple records, please attach a multiple record supplement to this request form.
Non-Certified Copy (5-year History - Convictions only)
Requester
Requester is
Payment made out to
IS subject
NOT subject
Driver & Vehicle
Certified Copy
Services
of data
of data
Non-Certified Copy
$9.00
$9.50
Certified Copy + Letter to show the date my driver's license was
(5 year history)
originally issued
Certified Copy
$10.00
$10.50
Specific details about driving record request:
Certified Copy +
License Issuance
$11.00
$11.50
Date Letter
B. Motor Vehicle Record Request
Vehicle Year & Make:
Minn. License Plate #:
Vehicle Identification Number:
Motor Vehicle Record
Requester
Requester is
Payment made out to
IS subject
NOT subject
Driver & Vehicle
Certified Motor Vehicle Record
Services
of data
of data
Non-Certified Copy
$9.00
$9.50
Title History
Certified Copy
$10.00
$10.50
Specific details about motor vehicle request:
$1.00 per printed pa
ge, in
addition to the record
Vehicle Title History
fee.
DVS USE ONLY
Remarks/Paid Stamp
Fee Charged
Proof of Requester's Identification
Valid Driver's License Number _________________________
$
Other Photo Identification _________________________
Page 1 of 4
PS2502A-20 (04/16)
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