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Mn self certification form 2012-2026

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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 operating status and may need to provide a medical examiner's certificate or waivers. 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 2012 in the editor.
Begin by entering your personal information in the 'Driver Information' section. Fill in your full name, Minnesota Driver's License Number, and Date of Birth.
Next, select one self-certification category that applies to you. Ensure you check only one box to avoid processing delays.
Answer the two questions regarding your medical examiner's certificate and any medical waivers. Mark 'Yes' or 'No' as applicable.
Finally, sign and date the form at the bottom. Review all entries for accuracy before submission.

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Versions	Form popularity	Fillable & printable
2021	4.8 Satisfied (61 Votes)
2014	4 Satisfied (53 Votes)
2013	4.1 Satisfied (75 Votes)
2012	4.2 Satisfied (72 Votes)

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