Form PS2231-01 "New Prorate Applicant Questionnaire" - Minnesota

What Is Form PS2231-01?

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, 2007;
  • 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 printable version of Form PS2231-01 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 PS2231-01 "New Prorate Applicant Questionnaire" - Minnesota

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New Prorate Applicant Questionnaire
Office Use Only
Prorate Acct. #:
Full Name (print):
Date:
Business Name (if any):
Contact Phone:
Why are you being asked to share this information and how will it be used?
The Department of Public Safety (DPS) will use the information to determine your eligibility for Minnesota prorate registration, to access
your record for any future service transactions and/or inquiries, and to comply with state and federal laws.
State law authorizes collection of this information.
The International Registration Plan (IRP) entered into under the authority of Minnesota Statutes, section 168.187, subdivision 7,
requires this information.
Consequences of supplying or refusing to supply requested information.
If you supply the requested information, the DPS will be able to determine whether to issue you Minnesota title and prorate registration.
If you don’t provide the information requested, the DPS cannot issue you title or prorate registration and your eligibility for any current
registration may be affected.
How is the requested information shared with other agencies?
The DPS releases this information to local, state, and federal government agencies only as authorized or required by state and federal
law. This means that the information may be shared with the Federal Motor Carrier Safety Administration (FMCSA) and IRP member
states. In addition, your personal information may also be disclosed as authorized in the United States Code, title 18, section 2721.
1. What do you haul (check all that apply)?
General Freight
Mobil Homes
Grain, Feed, Hay
Utility
Household Goods
Machinery, Large
Meat
Farm Supplies
Metal
Beverages
Garbage, Refuse, Trash
Construction
Coal, Coke
Fresh Produce
US Postal Mail
Water Well
Motor Vehicles
Intermodal Containers
Chemicals
Other: __________
Drive Away, Tow
Passengers
Commodities: Dry, Bulk
_______________
Logs, Poles, Beams
Oil Field Equipment
Refrigerated Foods
_______________
Building Materials
Livestock
Paper Products
2. What type of operation is it?
Authorized for hire
Private; passengers
Construction
Indian Tribe
(non-buses)
Exempt for hire
Moving Company
Other: __________
Rental
Private; property
US mail
_______________
Farm
Private; carrier
Federal Government
_______________
Migrant
Private; passengers
State Government
_______________
(buses)
Bus
Local Government
3. How many vehicles are you prorating (include those you own that are leased to another company)? ______________
4. Where are these vehicles currently registered?
Minnesota
Other jurisdiction: ___________________________________________________________
5. How are these vehicles currently registered?
Base plate (list plate number(s)): _______________________________________________________________
__________________________________________________________________________________________
IRP plate (list plate number(s)): ________________________________________________________________
__________________________________________________________________________________________
New purchase from (seller’s name): _____________________________________________________________
Seller’s relationship to applicant (if any): _________________________________________________________
Other (explain in detail): ______________________________________________________________________
Minnesota Department of Public Safety Driver and Vehicle Services Division
PS2231-01 Rev. 5/2007
445 Minnesota Street Saint Paul, Minnesota 55101-5188
Office: (651) 205-4141 or TTY: (651) 282-6555
New Prorate Applicant Questionnaire
Office Use Only
Prorate Acct. #:
Full Name (print):
Date:
Business Name (if any):
Contact Phone:
Why are you being asked to share this information and how will it be used?
The Department of Public Safety (DPS) will use the information to determine your eligibility for Minnesota prorate registration, to access
your record for any future service transactions and/or inquiries, and to comply with state and federal laws.
State law authorizes collection of this information.
The International Registration Plan (IRP) entered into under the authority of Minnesota Statutes, section 168.187, subdivision 7,
requires this information.
Consequences of supplying or refusing to supply requested information.
If you supply the requested information, the DPS will be able to determine whether to issue you Minnesota title and prorate registration.
If you don’t provide the information requested, the DPS cannot issue you title or prorate registration and your eligibility for any current
registration may be affected.
How is the requested information shared with other agencies?
The DPS releases this information to local, state, and federal government agencies only as authorized or required by state and federal
law. This means that the information may be shared with the Federal Motor Carrier Safety Administration (FMCSA) and IRP member
states. In addition, your personal information may also be disclosed as authorized in the United States Code, title 18, section 2721.
1. What do you haul (check all that apply)?
General Freight
Mobil Homes
Grain, Feed, Hay
Utility
Household Goods
Machinery, Large
Meat
Farm Supplies
Metal
Beverages
Garbage, Refuse, Trash
Construction
Coal, Coke
Fresh Produce
US Postal Mail
Water Well
Motor Vehicles
Intermodal Containers
Chemicals
Other: __________
Drive Away, Tow
Passengers
Commodities: Dry, Bulk
_______________
Logs, Poles, Beams
Oil Field Equipment
Refrigerated Foods
_______________
Building Materials
Livestock
Paper Products
2. What type of operation is it?
Authorized for hire
Private; passengers
Construction
Indian Tribe
(non-buses)
Exempt for hire
Moving Company
Other: __________
Rental
Private; property
US mail
_______________
Farm
Private; carrier
Federal Government
_______________
Migrant
Private; passengers
State Government
_______________
(buses)
Bus
Local Government
3. How many vehicles are you prorating (include those you own that are leased to another company)? ______________
4. Where are these vehicles currently registered?
Minnesota
Other jurisdiction: ___________________________________________________________
5. How are these vehicles currently registered?
Base plate (list plate number(s)): _______________________________________________________________
__________________________________________________________________________________________
IRP plate (list plate number(s)): ________________________________________________________________
__________________________________________________________________________________________
New purchase from (seller’s name): _____________________________________________________________
Seller’s relationship to applicant (if any): _________________________________________________________
Other (explain in detail): ______________________________________________________________________
Minnesota Department of Public Safety Driver and Vehicle Services Division
PS2231-01 Rev. 5/2007
445 Minnesota Street Saint Paul, Minnesota 55101-5188
Office: (651) 205-4141 or TTY: (651) 282-6555
New Prorate Applicant Questionnaire
Page 2
6. Do you have bulk fuel tanks?
No
Yes, used for prorated vehicles only
Yes, used for prorated and non-prorated vehicles
7. If you have bulk fuel tanks, how is the fuel monitored and allocated (check all that apply)?
Individual fuel tickets
Log sheets
Meter readings
8. Have you ever had IRP registration in Minnesota or any other jurisdiction?
No
Yes (jurisdiction and registered name or account #): ______________________________________
9. In the last three years, have you been associated with a company or individual with a prorated account?
No
Yes (jurisdiction and registered name or account #): ______________________________________
________________________________________________________________________________
10. Have you ever been denied registration?
No
Yes (explain in detail): ______________________________________________________________
11. Has your registration ever been suspended and/or revoked?
No
Yes (explain in detail): ______________________________________________________________
12. Is(are) your vehicle(s) presently leased to an individual or company?
No
Yes (lessee name, address, and phone number): _________________________________________
13. Under what authority (USDOT number displayed on vehicle) are you operating? _____________________________
Jurisdiction of issuance: _________________________________________________________________________
Authority holder (self or name, address, phone): ______________________________________________________
14. Have you ever been audited by Minnesota or another IRP member jurisdiction?
No
Yes (approximate date, jurisdiction): ___________________________________________________
15. Has(have) your vehicle(s) accrued actual mileage (past mileage history)?
No
Yes (explain) _____________________________________________________________________
16. Have you been instructed on the importance of maintaining vehicle distance records?
No
Yes
17. Address where records will be maintained for audit purposes: ____________________________________________
_____________________________________________________________________________________________
18. Who will be responsible for filing IRP returns? ________________________________________________________
19. Who will be responsible for filing IFTA returns? ________________________________________________________
20. Additional information/questions: ___________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
I hereby affirm that the information provided is true and correct. The registrant is familiar with the record keeping and
mileage recording requirements imposed by the International Registration Plan (IRP) and International Fuel Tax
Agreement (IFTA). The operational records and any other pertinent information required by the base jurisdiction
(Minnesota) are available upon request. The registrant is in compliance with the laws requiring insurance while
operating motor vehicles upon public roads and will maintain the required insurance coverage.
_____________________________________________________________
______________________
Signature, Title
Date
Minnesota Department of Public Safety Driver and Vehicle Services Division
PS2231-01 Rev. 5/2007
445 Minnesota Street Saint Paul, Minnesota 55101-5188
Office: (651) 205-4141 or TTY: (651) 282-6555
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