Form PS31300-10 "Law Enforcement Alert for Victims of Identity Theft" - Minnesota

What Is Form PS31300-10?

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 May 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 PS31300-10 by clicking the link below or browse more documents and templates provided by the Minnesota Department of Public Safety.

ADVERTISEMENT
ADVERTISEMENT

Download Form PS31300-10 "Law Enforcement Alert for Victims of Identity Theft" - Minnesota

Download PDF

Fill PDF online

Rate (4.5 / 5) 39 votes
Page background image
Print Form
MINNESOTA DEPARTMENT OF PUBLIC SAFETY
DRIVER AND VEHICLE SERVICES
L aw En forcemen t Al ert f or Vict ims of Identit y Theft
• The Minnesota Department of Public Safety recognizes that the misuse of your identity by someone else is a serious
problem. Upon receipt of this completed form, an entry will be made on your driving record. This entry will alert law
enforcement officers that someone else may be using your identity.
• This entry should prevent someone from using your name when involved with law enforcement.
• It is important for you to know that this entry may cause you inconvenience if you have contact with law enforcement
personnel as they will specifically request your identification. For your own protection, it is recommended that you have
your Minnesota driver's license or identification card with you at all times.
• This form will not prevent the use of your name in financial matters, such as establishing credit or other
accounts.
• If you have questions or need additional information, please contact DVS at (651) 296-2025 or (651) 282-6555 (TTY).
If you choose to have this entry placed on your record, please submit this form by mail to:
Driver and Vehicle Services, 445 Minnesota Street - Suite 175, St. Paul, MN 55101, or in person at any driver exam station or
driver license office that accepts applications. Refer to the Driver and Vehicle Services website for a list of locations.
Name (
)
Date of Birth
LAST, FIRST, MIDDLE INITIAL
(mm/dd/yy)
-
-
-
-
Driver's License Number
I request that an entry is placed on my driving record to alert law enforcement personnel that someone else may be using my
identity. I understand that this entry will remain on my record until I send a written request to Driver and Vehicle Services to
remove it.
Signature
Date
(mm/dd/yy)
Witness
Date
(
)
(mm/dd/yy)
NOTARY PUBLIC OR DRIVER AND VEHICLE SERVICES REPRESENTATIVE
Subscribed and sworn to before me this
day of _______ 20 _____
NOTARY PUBLIC
COUNTY:
MY COMISSION EXPIRES:
PS31300-10 (05/16)
Print Form
MINNESOTA DEPARTMENT OF PUBLIC SAFETY
DRIVER AND VEHICLE SERVICES
L aw En forcemen t Al ert f or Vict ims of Identit y Theft
• The Minnesota Department of Public Safety recognizes that the misuse of your identity by someone else is a serious
problem. Upon receipt of this completed form, an entry will be made on your driving record. This entry will alert law
enforcement officers that someone else may be using your identity.
• This entry should prevent someone from using your name when involved with law enforcement.
• It is important for you to know that this entry may cause you inconvenience if you have contact with law enforcement
personnel as they will specifically request your identification. For your own protection, it is recommended that you have
your Minnesota driver's license or identification card with you at all times.
• This form will not prevent the use of your name in financial matters, such as establishing credit or other
accounts.
• If you have questions or need additional information, please contact DVS at (651) 296-2025 or (651) 282-6555 (TTY).
If you choose to have this entry placed on your record, please submit this form by mail to:
Driver and Vehicle Services, 445 Minnesota Street - Suite 175, St. Paul, MN 55101, or in person at any driver exam station or
driver license office that accepts applications. Refer to the Driver and Vehicle Services website for a list of locations.
Name (
)
Date of Birth
LAST, FIRST, MIDDLE INITIAL
(mm/dd/yy)
-
-
-
-
Driver's License Number
I request that an entry is placed on my driving record to alert law enforcement personnel that someone else may be using my
identity. I understand that this entry will remain on my record until I send a written request to Driver and Vehicle Services to
remove it.
Signature
Date
(mm/dd/yy)
Witness
Date
(
)
(mm/dd/yy)
NOTARY PUBLIC OR DRIVER AND VEHICLE SERVICES REPRESENTATIVE
Subscribed and sworn to before me this
day of _______ 20 _____
NOTARY PUBLIC
COUNTY:
MY COMISSION EXPIRES:
PS31300-10 (05/16)