Form PS33110 "School Bus Criminal Records Check Authorization" - Minnesota

What Is Form PS33110?

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 November 1, 2015;
  • 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 PS33110 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 PS33110 "School Bus Criminal Records Check Authorization" - Minnesota

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STATE OF MINNESOTA
MINNESOTA DEPARTMENT OF PUBLIC SAFETY
SCHOOL BUS CRIMINAL RECORDS CHECK AUTHORIZATION
Before issuing a school bus endorsement, the Commissioner of Public Safety is required to conduct a criminal records
check of the applicant (Minnesota Statutes, § 171.321, Subd. 3). The criminal records check will be conducted by the
Minnesota Bureau of Criminal Apprehension (BCA).
If you have resided in Minnesota for less than five years, the check will also include a national criminal records
check conducted by the FBI. The criminal records check by the FBI will take additional time, which could delay
the application process. You must contact the Department of Public Safety to obtain the procedures to begin the
FBI national criminal records check and the current price for the check. There is no additional fee associated with
the BCA check; however, there is an additional fee to conduct the FBI check.
The Department of Public Safety will notify you in writing of the results of the criminal records check(s). The Department
will use the criminal background criteria set forth in Minnesota Statues, §171.3215, when issuing or denying an
application for a school bus driver’s endorsement. The results of the criminal records check will not be released to anyone
but the Department of Public Safety and you. The failure to cooperate with the department in conducting the criminal
records check is reasonable cause to deny your application.
If you have any questions please call (651) 297-5029, or TDD (651) 282-6555 or write to:
Department of Public Safety, Commercial Driver License Unit, 445 Minnesota St., Suite 180, St. Paul, MN 55101-5180.
Please email this form to:
dvs.sb.pre-app@state.mn.us
Or, fax to: (651) 282-2110 or mail to the above address
“I, the applicant, authorize the Department of Public Safety to conduct a check of my criminal history as required by
Minnesota Statutes, §171.321, Subd. 3.”
APPLICANT
PROSPECTIVE EMPLOYER
Applicant's Full Name (please print or type)
Applicant's Maiden Name, Previous Name(s) Used
Name of Prospective Employer
Applicant's Street Address
Prospective Employer's Street Address
Applicant's City, State, Zip code
Prospective Employer's City, State, Zip code
Applicant's Driver's License Number
Contact Person of Prospective Employer
Applicant's Date of Birth
Contact Person's Phone Number
Applicant's Signature
Authorized Signature of Prospective Employer
PS33110-12 (11/15)
STATE OF MINNESOTA
MINNESOTA DEPARTMENT OF PUBLIC SAFETY
SCHOOL BUS CRIMINAL RECORDS CHECK AUTHORIZATION
Before issuing a school bus endorsement, the Commissioner of Public Safety is required to conduct a criminal records
check of the applicant (Minnesota Statutes, § 171.321, Subd. 3). The criminal records check will be conducted by the
Minnesota Bureau of Criminal Apprehension (BCA).
If you have resided in Minnesota for less than five years, the check will also include a national criminal records
check conducted by the FBI. The criminal records check by the FBI will take additional time, which could delay
the application process. You must contact the Department of Public Safety to obtain the procedures to begin the
FBI national criminal records check and the current price for the check. There is no additional fee associated with
the BCA check; however, there is an additional fee to conduct the FBI check.
The Department of Public Safety will notify you in writing of the results of the criminal records check(s). The Department
will use the criminal background criteria set forth in Minnesota Statues, §171.3215, when issuing or denying an
application for a school bus driver’s endorsement. The results of the criminal records check will not be released to anyone
but the Department of Public Safety and you. The failure to cooperate with the department in conducting the criminal
records check is reasonable cause to deny your application.
If you have any questions please call (651) 297-5029, or TDD (651) 282-6555 or write to:
Department of Public Safety, Commercial Driver License Unit, 445 Minnesota St., Suite 180, St. Paul, MN 55101-5180.
Please email this form to:
dvs.sb.pre-app@state.mn.us
Or, fax to: (651) 282-2110 or mail to the above address
“I, the applicant, authorize the Department of Public Safety to conduct a check of my criminal history as required by
Minnesota Statutes, §171.321, Subd. 3.”
APPLICANT
PROSPECTIVE EMPLOYER
Applicant's Full Name (please print or type)
Applicant's Maiden Name, Previous Name(s) Used
Name of Prospective Employer
Applicant's Street Address
Prospective Employer's Street Address
Applicant's City, State, Zip code
Prospective Employer's City, State, Zip code
Applicant's Driver's License Number
Contact Person of Prospective Employer
Applicant's Date of Birth
Contact Person's Phone Number
Applicant's Signature
Authorized Signature of Prospective Employer
PS33110-12 (11/15)