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Mn self certification form 2013-2026

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The document is a Commercial Driver License Medical Self-Certification Form from the Minnesota Department of Public Safety. It requires all commercial driver's license (CDL) holders to complete and submit the form for initial, renewal, or change in class applications. CDL holders must indicate their medical status and submit a current medical examiner's certificate if applicable. The document also includes a Tennessen warning explaining the use of personal information collected.

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Click ‘Get Form’ to open the mn self certification form 2013 in the editor.
Begin by entering your Driver Information. Fill in your full name, Minnesota Driver's License Number, and Date of Birth in the designated fields.
Next, select your commercial operating status by checking only one category box that applies to you. Ensure you check only one to avoid processing delays.
Answer the two questions regarding the submission of your medical examiner's certificate and any medical waivers. Check 'Yes' or 'No' as applicable.
Finally, sign and date the form at the bottom. Review all entries for accuracy before submitting.

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