Form PS2067B-16 "Application for Duplicate Plates and/or Stickers" - Minnesota

What Is Form PS2067B-16?

This is a legal form that was released by the Minnesota Department of Public Safety - a government authority operating within Minnesota. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2016;
  • The latest edition provided by the Minnesota Department of Public Safety;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form PS2067B-16 by clicking the link below or browse more documents and templates provided by the Minnesota Department of Public Safety.

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Download Form PS2067B-16 "Application for Duplicate Plates and/or Stickers" - Minnesota

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New Plate Number Issued
YEAR
MINNESOTA DEPARTMENT OF PUBLIC SAFETY
Print Form
DRIVER AND VEHICLE SERVICES
445 Minnesota Street Saint Paul, MN 55101-5160
New Year Validation Sticker No. Issued
YEAR
Phone: (651) 297-2126 TTY: (651) 282-6555 Web: dvs.dps.mn.gov
APPLICATION FOR DUPLICATE PLATES AND/OR STICKERS
New Weight Sticker No. Issued
PLEASE READ INSTRUCTIONS BELOW BEFORE COMPLETING
CENTRAL OFFICE USE ONLY
CENTRAL OFFICE USE ONLY
A Duplicate Title is NOT required when applying for duplicate plates or stickers
VEHICLE IDENTIFICATION NUMBER
CURRENT
EXPIRATION DATE
CURRENT PLATE NUMBER
MAKE
TYPE
MODEL YEAR
MONTH
YEAR
/
LAST, FIRST AND MIDDLE NAME
DRIVER'S LICENSE NUMBER
PRINT NAME OF OWNER(S)
u
STREET ADDRESS
CITY
COUNTY
STATE
ZIP CODE
PRINT ADDRESS OF
FIRST OWNER
u
(PERMANENT ADDRESS)
FEES DUE
THIS APPLICATION IS FOR DUPLICATE (Please check all that apply):
PLATES
WEIGHT STICKERS
YEAR STICKER
I am replacing the
The registration plates, year stickers and/or month stickers for this
stickers for the
DUPLICATE
vehicle must be replaced because they were (check all that apply):
MONTH of:
STOLEN
LOST
DEFECTIVE
FILING
DESTROYED
SURRENDERED
NEVER RECEIVED
YEAR of:
ISSUED IN ERROR
TOTAL
I (WE), HAVING BEEN DULY SWORN, DO CERTIFY ALL OF MY (OUR) DECLARATION ARE TRUE AND CORRECT AND THIS VEHICLE IS AND WILL CONTINUE TO BE
INSURED WHILE BEING OPERATED UPON THE PUBLIC STREETS AND HIGHWAYS.
X
DATE
OWNER'S SIGNATURE
If plates and/or stickers must be sent to a temporary address, print address here:
STREET ADDRESS
CITY
STATE
ZIP CODE
INSTRUCTIONS: Please Read Carefully Before Completing Form
1. Complete this application on this side only. PLEASE PRINT OR TYPE.
2. Attach this vehicle's current registration card.
I cannot attach the current registration card because it was:
LOST
DESTROYED
NEVER RECEIVED
I am currently driving outside the state of Minnesota and
must retain the registration card for proof of registration.
3. “Never Received” applies ONLY to plates and/or stickers mailed by the Driver and Vehicle Services Division.
Yes
No
In an attempt to find my plates and/or stickers I have contacted the Postal Service?
PRORATE CUSTOMERS ONLY:
20
If yes, when did you contact the Postal Service?
Prorate Cab Card Must be Surrendered
UNIT #:
4. “Surrendered” applies ONLY to plates and/or stickers which were surrendered due to lack of insurance coverage.
5. To determine the fees due or to obtain assistance in completing this application, contact:
ACCOUNT #:
A deputy registrar or the Department of Public Safety, Driver and Vehicle Services Division
Make remittance payable to: The Driver and Vehicle Services Division
IMPORTANT NOTICE: PLEASE READ
The month and/or year stickers you are replacing MUST match the stickers originally on this vehicle. This application for duplicate plates and/or stickers must be completed
by the person(s) in whose name(s) this vehicle is now registered, and the registration card and any remaining plates and/or stickers must be surrendered to the registrar for
cancellation.
All data collected on a motor vehicle application are required by law. These data are used to identify your motor vehicle. Failure to provide required data may result in denial
of the transfer of ownership, registration of this vehicle or other requested action. Except for certain uses permitted by federal and state laws, personal information contained
in your application may not be disclosed to anyone without your express consent.
PS2067B-16 (01/16)
New Plate Number Issued
YEAR
MINNESOTA DEPARTMENT OF PUBLIC SAFETY
Print Form
DRIVER AND VEHICLE SERVICES
445 Minnesota Street Saint Paul, MN 55101-5160
New Year Validation Sticker No. Issued
YEAR
Phone: (651) 297-2126 TTY: (651) 282-6555 Web: dvs.dps.mn.gov
APPLICATION FOR DUPLICATE PLATES AND/OR STICKERS
New Weight Sticker No. Issued
PLEASE READ INSTRUCTIONS BELOW BEFORE COMPLETING
CENTRAL OFFICE USE ONLY
CENTRAL OFFICE USE ONLY
A Duplicate Title is NOT required when applying for duplicate plates or stickers
VEHICLE IDENTIFICATION NUMBER
CURRENT
EXPIRATION DATE
CURRENT PLATE NUMBER
MAKE
TYPE
MODEL YEAR
MONTH
YEAR
/
LAST, FIRST AND MIDDLE NAME
DRIVER'S LICENSE NUMBER
PRINT NAME OF OWNER(S)
u
STREET ADDRESS
CITY
COUNTY
STATE
ZIP CODE
PRINT ADDRESS OF
FIRST OWNER
u
(PERMANENT ADDRESS)
FEES DUE
THIS APPLICATION IS FOR DUPLICATE (Please check all that apply):
PLATES
WEIGHT STICKERS
YEAR STICKER
I am replacing the
The registration plates, year stickers and/or month stickers for this
stickers for the
DUPLICATE
vehicle must be replaced because they were (check all that apply):
MONTH of:
STOLEN
LOST
DEFECTIVE
FILING
DESTROYED
SURRENDERED
NEVER RECEIVED
YEAR of:
ISSUED IN ERROR
TOTAL
I (WE), HAVING BEEN DULY SWORN, DO CERTIFY ALL OF MY (OUR) DECLARATION ARE TRUE AND CORRECT AND THIS VEHICLE IS AND WILL CONTINUE TO BE
INSURED WHILE BEING OPERATED UPON THE PUBLIC STREETS AND HIGHWAYS.
X
DATE
OWNER'S SIGNATURE
If plates and/or stickers must be sent to a temporary address, print address here:
STREET ADDRESS
CITY
STATE
ZIP CODE
INSTRUCTIONS: Please Read Carefully Before Completing Form
1. Complete this application on this side only. PLEASE PRINT OR TYPE.
2. Attach this vehicle's current registration card.
I cannot attach the current registration card because it was:
LOST
DESTROYED
NEVER RECEIVED
I am currently driving outside the state of Minnesota and
must retain the registration card for proof of registration.
3. “Never Received” applies ONLY to plates and/or stickers mailed by the Driver and Vehicle Services Division.
Yes
No
In an attempt to find my plates and/or stickers I have contacted the Postal Service?
PRORATE CUSTOMERS ONLY:
20
If yes, when did you contact the Postal Service?
Prorate Cab Card Must be Surrendered
UNIT #:
4. “Surrendered” applies ONLY to plates and/or stickers which were surrendered due to lack of insurance coverage.
5. To determine the fees due or to obtain assistance in completing this application, contact:
ACCOUNT #:
A deputy registrar or the Department of Public Safety, Driver and Vehicle Services Division
Make remittance payable to: The Driver and Vehicle Services Division
IMPORTANT NOTICE: PLEASE READ
The month and/or year stickers you are replacing MUST match the stickers originally on this vehicle. This application for duplicate plates and/or stickers must be completed
by the person(s) in whose name(s) this vehicle is now registered, and the registration card and any remaining plates and/or stickers must be surrendered to the registrar for
cancellation.
All data collected on a motor vehicle application are required by law. These data are used to identify your motor vehicle. Failure to provide required data may result in denial
of the transfer of ownership, registration of this vehicle or other requested action. Except for certain uses permitted by federal and state laws, personal information contained
in your application may not be disclosed to anyone without your express consent.
PS2067B-16 (01/16)