Form PS31125 "Request for Administrative Review of License Plate Impoundment Order" - Minnesota

What Is Form PS31125?

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 February 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 PS31125 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 PS31125 "Request for Administrative Review of License Plate Impoundment Order" - Minnesota

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MINNESOTA DEPARTMENT OF PUBLIC SAFETY
Print Form
DRIVER AND VEHICLE SERVICES
445 Minnesota Street, Suite 166
Saint Paul, MN 55101-5166
Phone: (651) 297-5034 FAX: (651) 797-1810 TTY: (651) 282-6555
Web: dvs.dps.mn.gov
Req u es t f or A d mi n i s t ra tiv e Re view of L ic ense Pla te Impoundment Or der
SECTION A
MAKE
MODEL YEAR
VEHICLE IDENTIFICATION NUMBER
IMPOUNDED PLATE NUMBER
DRIVER'S FULL NAME AT TIME OF INCIDENT
DATE OF BIRTH
DRIVER'S LICENSE NUMBER
INCIDENT DATE
DRIVER'S FULL ADDRESS AT TIME OF INCIDENT
OWNER'S OR PURCHASER'S FULL NAME
DATE OF BIRTH
DRIVER'S LICENSE NUMBER
OWNER'S OR PURCHASER'S ADDRESS AT TIME OF INCIDENT
OWNER'S OR PURCHASER'S CURRENT ADDRESS (if different from address at the time of incident)
REQUEST FOR ADMINISTRATIVE REVIEW BY THE VEHICLE OWNER WHO WAS NOT THE VIOLATOR/OPERATOR
SECTION B
It is important that you include all the required information when you request the review. You are entitled to only one
administrative review. Complete Sections A, B, B2, and sign at the X below. Administrative reviews take up to 15
days to process.
I request the plate impoundment order for the above-described vehicle be rescinded. I am the owner and possessor of the vehicle. Neither I nor any
co-owners were driving nor were passengers in the vehicle at the time of the violation. I know that the violator may not drive, operate, or be in
physical control of a vehicle without a valid driver’s license.
The above listed driver obtained the vehicle from me on (date)
DVS may rescind the plate impoundment order as it affects the vehicle and issue new plates at no fee if:
SECTION B2
The Violator/Operator of the vehicle is not a registered owner of the vehicle, and the owner of the vehicle was not a passenger, AND
Check One:
1. At the time of the incident, the violator had a valid driver’s license.
2. A report was filed with law enforcement BEFORE the incident stating that the vehicle had been taken from the person’s possession
or was being used without permission. A copy of the police report must be submitted with the request for a review.
If you do not qualify to obtain new passenger plates, you may request Special Registration plates.
You may petition for Judicial Review within 30 days of the qualifying incident even if the Administrative Review is sustained.
X
Signature of Vehicle Owner:
REQUEST TO APPROVE SALE OF VEHICLE SUBJECT TO LICENSE PLATE IMPOUNDMENT
Purchaser must complete Sections A and C, and sign at X below. Incomplete information may cause transfer to be
SECTION C
delayed or denied.
A registered owner may not sell a vehicle while the license plates are impounded or while special registration plates are displayed on the vehicle unless:
• The sale is for valid consideration (Fair Market Value)
“Gifts” are not acceptable, Low purchase prices must be accompanied by estimates from an auto repair business.
• The purchaser and registered owner or violator have no significant relationship (as defined under M.S. 169A.60) and are not related by blood, marriage, or
adoption.
• The purchaser does not reside in the same residence as the registered owner or violator.
PURCHASER’S STATEMENT: Please read, check the box to the left, and sign at the “X” below:
• I request authorization to transfer the ownership of the above-described vehicle.
• I have purchased the vehicle for $
which I attest is valid consideration.
• I am not related by blood, marriage, or adoption to the registered owner or violator.
• I do not reside in the same household as the owner or violator.
• I have no significant relation as defined in M.S. 169A.60 with the registered owner or violator. (A “significant relation” is defined as any person with whom
the actor (violator/owner) regularly associates and communicates with outside of a workplace setting.)
• I know that an individual may not drive, operate, or be in physical control of a vehicle without a valid driver's license.
• I understand that a false or fraudulent statement may be a gross misdemeanor or felony.
X
Signature of Purchaser:
IMPORTANT NOTICE: PLEASE READ
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. You are
advised that information given in this form may be used in any court related action involving your plate impoundment including any criminal charges that may result from this incident.
-OVER-
PS31125-14 Rev. 02/16
MINNESOTA DEPARTMENT OF PUBLIC SAFETY
Print Form
DRIVER AND VEHICLE SERVICES
445 Minnesota Street, Suite 166
Saint Paul, MN 55101-5166
Phone: (651) 297-5034 FAX: (651) 797-1810 TTY: (651) 282-6555
Web: dvs.dps.mn.gov
Req u es t f or A d mi n i s t ra tiv e Re view of L ic ense Pla te Impoundment Or der
SECTION A
MAKE
MODEL YEAR
VEHICLE IDENTIFICATION NUMBER
IMPOUNDED PLATE NUMBER
DRIVER'S FULL NAME AT TIME OF INCIDENT
DATE OF BIRTH
DRIVER'S LICENSE NUMBER
INCIDENT DATE
DRIVER'S FULL ADDRESS AT TIME OF INCIDENT
OWNER'S OR PURCHASER'S FULL NAME
DATE OF BIRTH
DRIVER'S LICENSE NUMBER
OWNER'S OR PURCHASER'S ADDRESS AT TIME OF INCIDENT
OWNER'S OR PURCHASER'S CURRENT ADDRESS (if different from address at the time of incident)
REQUEST FOR ADMINISTRATIVE REVIEW BY THE VEHICLE OWNER WHO WAS NOT THE VIOLATOR/OPERATOR
SECTION B
It is important that you include all the required information when you request the review. You are entitled to only one
administrative review. Complete Sections A, B, B2, and sign at the X below. Administrative reviews take up to 15
days to process.
I request the plate impoundment order for the above-described vehicle be rescinded. I am the owner and possessor of the vehicle. Neither I nor any
co-owners were driving nor were passengers in the vehicle at the time of the violation. I know that the violator may not drive, operate, or be in
physical control of a vehicle without a valid driver’s license.
The above listed driver obtained the vehicle from me on (date)
DVS may rescind the plate impoundment order as it affects the vehicle and issue new plates at no fee if:
SECTION B2
The Violator/Operator of the vehicle is not a registered owner of the vehicle, and the owner of the vehicle was not a passenger, AND
Check One:
1. At the time of the incident, the violator had a valid driver’s license.
2. A report was filed with law enforcement BEFORE the incident stating that the vehicle had been taken from the person’s possession
or was being used without permission. A copy of the police report must be submitted with the request for a review.
If you do not qualify to obtain new passenger plates, you may request Special Registration plates.
You may petition for Judicial Review within 30 days of the qualifying incident even if the Administrative Review is sustained.
X
Signature of Vehicle Owner:
REQUEST TO APPROVE SALE OF VEHICLE SUBJECT TO LICENSE PLATE IMPOUNDMENT
Purchaser must complete Sections A and C, and sign at X below. Incomplete information may cause transfer to be
SECTION C
delayed or denied.
A registered owner may not sell a vehicle while the license plates are impounded or while special registration plates are displayed on the vehicle unless:
• The sale is for valid consideration (Fair Market Value)
“Gifts” are not acceptable, Low purchase prices must be accompanied by estimates from an auto repair business.
• The purchaser and registered owner or violator have no significant relationship (as defined under M.S. 169A.60) and are not related by blood, marriage, or
adoption.
• The purchaser does not reside in the same residence as the registered owner or violator.
PURCHASER’S STATEMENT: Please read, check the box to the left, and sign at the “X” below:
• I request authorization to transfer the ownership of the above-described vehicle.
• I have purchased the vehicle for $
which I attest is valid consideration.
• I am not related by blood, marriage, or adoption to the registered owner or violator.
• I do not reside in the same household as the owner or violator.
• I have no significant relation as defined in M.S. 169A.60 with the registered owner or violator. (A “significant relation” is defined as any person with whom
the actor (violator/owner) regularly associates and communicates with outside of a workplace setting.)
• I know that an individual may not drive, operate, or be in physical control of a vehicle without a valid driver's license.
• I understand that a false or fraudulent statement may be a gross misdemeanor or felony.
X
Signature of Purchaser:
IMPORTANT NOTICE: PLEASE READ
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. You are
advised that information given in this form may be used in any court related action involving your plate impoundment including any criminal charges that may result from this incident.
-OVER-
PS31125-14 Rev. 02/16
Request for Admin Review of License Plate
Impoundment Order
INFORMATION
NOTICE AND ORDER OF LICENSE PLATE IMPOUNDMENT
TO: Owner/Violator
REQUEST FOR AN ADMINISTRATIVE REVIEW
You have the right to an administrative review of an order of license plate impoundment. The information regarding the impoundment will be
reviewed only upon your written request, which may be made at any time during the impoundment period. DVS may rescind the plate impound
order and allow the vehicle to obtain new plates at no fee only if:
• The violator is not an owner of the vehicle.
• The owner of the vehicle was not a passenger at the time of the incident, and
• The violator had a valid driver's license at the time of the incident or,
• A report was filed with law enforcement before the incident stating that the vehicle had been taken from the owner's possession or
was being used without permission. A copy of the police report must be submitted with the request for a review.
ELIGIBILITY FOR SPECIAL REGISTRATION PLATES
Special series license plates may be issued to a vehicle owner if they have a valid or limited license. You may also request in writing that
special registration plates be issued to a qualified driver who has a need to operate the vehicle and has a valid or limited driver's license.
PETITION FOR JUDICIAL REVIEW
You have the right to petition the court in the county in which the incident occurred for judicial review of the license plate impoundment order.
The petition must be made to the court within 30 days of the notice. The judicial review of the license plate impoundment order shall take place
at the same time as any judicial review of a driver license revocation.
ACQUIRING A NEW OR USED VEHICLE DURING THE IMPOUNDMENT PERIOD
Pursuant to M.S. 169A.60, if during the effective period of the plate impound the violator applies for registration plates for any vehicle; the
commissioner shall not issue plates unless the violator qualifies for special registration plates. If the violator acquires a new or used vehicle
during the plate impoundment period, (as sole or joint owner or lessee) the newly acquired vehicle may only display special registration plates
and all qualifications are met.
SALE OF VEHICLE SUBJECT TO IMPOUNDMENT ORDER
A registered owner may not sell a vehicle while the license plates are impounded or while special registration plates are displayed on the
vehicle unless;
• The sale is for valid consideration (fair market value) “Gifts” will not be approved. Low purchase prices must be explained
with estimates from an auto repair business.
• The purchaser does not reside in the same household as the violator or owner
• The purchaser is not and has not been related by blood, marriage or adoption to the violator or owner
• The purchaser does not have a significant relationship with the violator or owner
“Significant Relation” is defined in M.S. 169A.60 “any person with whom the actor (violator or owner) regularly associates
and communicates with outside of a workplace setting”
The buyer is required to file a signed statement in addition to the required transfer documents and fees to obtain authorization from
Driver and Vehicle Services, Plate Impound, at the time of the transfer.
REINSTATEMENT OF THE LICENSE PLATES AND REGISTRATION
The plate impound period is in effect during the time the violator's drivers license status is canceled or for at least one year from the date of
qualifying incident and until the following registration renewal, whichever period of time is longer. Once all the requirements are met, (a limited
license is not a reinstatement), you may qualify for regular license plates for your vehicle. The plate impound period for non-violator owners is at
least one year from the date of qualifying incident and until the following registration renewal.
Pursuant to M.S. 169A.60, a $50.00 plate reinstatement fee is due in addition to plate application and registration fees.
PS31125-14 Rev. 02/16
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