Form PS2261-20 "Ifta License and Decals Application" - Minnesota

What Is Form PS2261-20?

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 July 1, 2019;
  • 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 PS2261-20 by clicking the link below or browse more documents and templates provided by the Minnesota Department of Public Safety.

ADVERTISEMENT
ADVERTISEMENT

Download Form PS2261-20 "Ifta License and Decals Application" - Minnesota

268 times
Rate (4.5 / 5) 19 votes
IFTA License and Decals Application
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 identify you as a registrant or authorized agent of the
registrant, to create or identify your Minnesota prorate account, to determine your eligibility for a Minnesota IFTA license and
decals, 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 Fuel Tax Agreement (IFTA) 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 a Minnesota IFTA license and
decals. If you don’t provide the information requested, the DPS cannot issue you a Minnesota IFTA license and decals 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.
Permissible Uses of Motor Vehicle Data as provided in United States Code, title 18, section 2721
1.
For use by any government agency, including court or law enforcement agency, in carrying out its functions, or any private person
or entity acting on behalf of a federal, state or local agency in carrying out its functions.
2.
For use in connection with matters of motor vehicle or driver safety and theft; motor vehicle emissions; motor vehicle product
alterations, recalls or advisories; performance monitoring of motor vehicles, motor vehicle parts and dealers; motor vehicle market
research activities, including survey research; and removal of non-owner records from the original owner records of motor vehicle
manufacturers.
3.
For use in the normal course of business by a legitimate business or its agents, employees, or contractors, but only:
(A) to verify the accuracy of personal information submitted by the individual to the business or its agencies, employees, or
contractors; and
(B) if such information as so submitted is not correct or is no longer correct, to obtain correct information, but only for the purposes
of preventing fraud by, pursuing legal remedies against, or recovering on a debt or security interest against the individual.
4.
For use in connection with any civil, criminal, administrative, or arbitral proceeding in any federal, state or local court or agency or
before any self-regulatory body, including the service of process, investigation in anticipation of litigation, and the execution or
enforcement of judgments and orders, or pursuant to an order of a federal, state or local court.
5.
For use in research activities, and for use in producing statistical reports, so long as the personal information is not published, re-
disclosed, or used to contact individuals.
6.
For use by any insurer or insurance support organization, or by self-insured entity, or its agents, employees, or contractors, in
connection with claims investigation activities, antifraud activities, rating or underwriting.
7.
For use in providing notice to the owners of towed or impounded vehicles.
8.
For use by any licensed private investigative agency or licensed security service for any purpose permitted under this subsection.
9.
For use by an employer or its agent or insurer to obtain or verify information relating to a holder of a commercial driver’s license
that is required under the Commercial Motor Vehicle Safety Act of 1986 (49 U.S.C. App. 2710 et seq.).
10. For use in connection with the operation of private toll transportation facilities.
11. For any other use in response to requests for individual motor vehicle records if the state has obtained the express consent of the
person to whom such personal information pertains.
12. For bulk distribution for surveys, marketing, or solicitations if the state has obtained the express consent of the person to whom
such personal information pertains.
13. For use by any requester, if the requester demonstrates it has obtained written consent of the individual to whom the information
pertains.
14. For any other use specifically authorized under the law of the state that holds the record, if such use is related to the operation of a
motor vehicle or public safety.
PS2261-20 Rev. 07//2019
Minnesota Department of Public Safety Driver and Vehicle Services Division
445 Minnesota Street, Saint Paul, Minnesota 55101-5188 Office: (651) 205-4141 or TTY: (651) 282-6555
IFTA License and Decals Application
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 identify you as a registrant or authorized agent of the
registrant, to create or identify your Minnesota prorate account, to determine your eligibility for a Minnesota IFTA license and
decals, 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 Fuel Tax Agreement (IFTA) 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 a Minnesota IFTA license and
decals. If you don’t provide the information requested, the DPS cannot issue you a Minnesota IFTA license and decals 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.
Permissible Uses of Motor Vehicle Data as provided in United States Code, title 18, section 2721
1.
For use by any government agency, including court or law enforcement agency, in carrying out its functions, or any private person
or entity acting on behalf of a federal, state or local agency in carrying out its functions.
2.
For use in connection with matters of motor vehicle or driver safety and theft; motor vehicle emissions; motor vehicle product
alterations, recalls or advisories; performance monitoring of motor vehicles, motor vehicle parts and dealers; motor vehicle market
research activities, including survey research; and removal of non-owner records from the original owner records of motor vehicle
manufacturers.
3.
For use in the normal course of business by a legitimate business or its agents, employees, or contractors, but only:
(A) to verify the accuracy of personal information submitted by the individual to the business or its agencies, employees, or
contractors; and
(B) if such information as so submitted is not correct or is no longer correct, to obtain correct information, but only for the purposes
of preventing fraud by, pursuing legal remedies against, or recovering on a debt or security interest against the individual.
4.
For use in connection with any civil, criminal, administrative, or arbitral proceeding in any federal, state or local court or agency or
before any self-regulatory body, including the service of process, investigation in anticipation of litigation, and the execution or
enforcement of judgments and orders, or pursuant to an order of a federal, state or local court.
5.
For use in research activities, and for use in producing statistical reports, so long as the personal information is not published, re-
disclosed, or used to contact individuals.
6.
For use by any insurer or insurance support organization, or by self-insured entity, or its agents, employees, or contractors, in
connection with claims investigation activities, antifraud activities, rating or underwriting.
7.
For use in providing notice to the owners of towed or impounded vehicles.
8.
For use by any licensed private investigative agency or licensed security service for any purpose permitted under this subsection.
9.
For use by an employer or its agent or insurer to obtain or verify information relating to a holder of a commercial driver’s license
that is required under the Commercial Motor Vehicle Safety Act of 1986 (49 U.S.C. App. 2710 et seq.).
10. For use in connection with the operation of private toll transportation facilities.
11. For any other use in response to requests for individual motor vehicle records if the state has obtained the express consent of the
person to whom such personal information pertains.
12. For bulk distribution for surveys, marketing, or solicitations if the state has obtained the express consent of the person to whom
such personal information pertains.
13. For use by any requester, if the requester demonstrates it has obtained written consent of the individual to whom the information
pertains.
14. For any other use specifically authorized under the law of the state that holds the record, if such use is related to the operation of a
motor vehicle or public safety.
PS2261-20 Rev. 07//2019
Minnesota Department of Public Safety Driver and Vehicle Services Division
445 Minnesota Street, Saint Paul, Minnesota 55101-5188 Office: (651) 205-4141 or TTY: (651) 282-6555
IFTA License and Decals Application
_______
Registration Year:
New/Renewal License
Exemption
Extra Decals
Change Account Information
Cancel Account (Attach license and decals) or check box if destroyed, lost, mutilated
Prorate Account Name (print):
Prorate Acct. #
Physical Address of Business:
FEIN:
USDOT #
Business Mailing Address:
Contact Phone:
Exemptions – If you qualify for one of the following exemptions, check the appropriate box and sign this application.
Company holds a current IFTA license in a jurisdiction other than MN.
Jurisdiction: ___________ Acct. #: ______________________
Leased to carrier that reports fuel tax.
Carrier name: ____________________________ Jurisdiction: ___________ Acct. #:_______________________
Operating only two-axle vehicles with gross vehicle weight of 26,000 pounds or less.
If you do not qualify for an exemption, complete items 1 through 8 and sign this application.
1. Print names and titles of:
Owner(s)
Partner(s)
Corporate officer(s)
(Name)
(Name)
(Title)
(Title)
2. Fuel type(s) used (check all that apply):
4. Is your fuel return for a consolidated fleet
(vehicles registered in another IRP jurisdiction)?
Diesel
Gasoline
Other _____________
NO
YES in: ________________________
3. Do you maintain bulk storage?
NO
YES in MN
YES in: __________
IFTA Fees and Decals: If requesting extra decals only, do not include annual filing fee and annual license fee.
License and decals for the upcoming year must be displayed by February 28.
New/Renewal:
Annual filing fee
$11
Mail this application and check/money order for Grand total to:
Prorate Office
Annual license fee
$28
445 Minnesota Street
Decals: _______(vehicles) x $2.50
$
Saint Paul, Minnesota 55101-5188
Make check/money order payable to Driver & Vehicle Services
Grand total
$
I hereby affirm that the information provided is true, correct, and complete. I agree to comply with reporting, payment, record
keeping, and license display requirements as specified in the International Fuel Tax Agreement (IFTA). I understand that failure to
comply with these provisions is grounds for revocation of the IFTA license in all member jurisdictions and that the base jurisdiction
may withhold any refunds due if I am delinquent on payment of fuel taxes due any member jurisdiction.
_____________________________________________________________
_______________________
(Signature of Taxpayer)
(Title)
(Date)
PS2261-20 Rev. 07/19
Minnesota Department of Public Safety Driver and Vehicle Services Division
445 Minnesota Street, Saint Paul, Minnesota 55101-5188 Office: (651) 205-4141 or TTY: (651) 282-6555
Page of 2