Form PS33135 "Home School Driver's Education Affidavit" - Minnesota

What Is Form PS33135?

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 December 1, 2020;
  • 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 PS33135 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 PS33135 "Home School Driver's Education Affidavit" - Minnesota

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MINNESOTA DEPARTMENT OF PUBLIC SAFETY
Print Form
Driver and Vehicle Services
Visit us:
drive.mn.gov
Home School Driver’s Education Affidavit
Submit by mail:
Driver and Vehicle Services, 445 Minnesota Street, Suite 176, St. Paul, Minnesota 55101
Submit by email:
driver.education@state.mn.us
Submit by fax: 651-296-5316
th
This affidavit cannot be accepted more than 30 days before your child's 15
birthday.
I certify that my child is currently receiving full-time instruction in a home school within the meaning of Minn. Stat. §§
120A.22
and 120A.24, and is working toward a home school diploma, and has completed a minimum of 30 hours of
driver training classroom instruction using materials approved by the commissioner of public safety pursuant to Minn.
Stat. § 171.05.
Student's Full Legal Name:
Middle
Last
First
Birth:
Student's Date of
Name of approved classroom materials used:
Parent's Name:
Email Address:
Street Address:
City:
State:
Zip Code:
Phone Number
:
Name of School District:
School District Phone Number:
Page 1 of 2
PS33135-06 (12/2020)
MINNESOTA DEPARTMENT OF PUBLIC SAFETY
Print Form
Driver and Vehicle Services
Visit us:
drive.mn.gov
Home School Driver’s Education Affidavit
Submit by mail:
Driver and Vehicle Services, 445 Minnesota Street, Suite 176, St. Paul, Minnesota 55101
Submit by email:
driver.education@state.mn.us
Submit by fax: 651-296-5316
th
This affidavit cannot be accepted more than 30 days before your child's 15
birthday.
I certify that my child is currently receiving full-time instruction in a home school within the meaning of Minn. Stat. §§
120A.22
and 120A.24, and is working toward a home school diploma, and has completed a minimum of 30 hours of
driver training classroom instruction using materials approved by the commissioner of public safety pursuant to Minn.
Stat. § 171.05.
Student's Full Legal Name:
Middle
Last
First
Birth:
Student's Date of
Name of approved classroom materials used:
Parent's Name:
Email Address:
Street Address:
City:
State:
Zip Code:
Phone Number
:
Name of School District:
School District Phone Number:
Page 1 of 2
PS33135-06 (12/2020)
Tennessen Warning
What is the purpose of supplying the requested information?
The Department of Public Safety (“DPS”) collects the information on this form for identification purposes, to verify
home school instruction and the Minnesota Government Data Practices Act, Minn. Stat. § 13.04(2).
Am I required to provide the requested information?
You are not legally required to complete this form.
What will happen if I do not provide the requested information?
If you do not provide this information, DPS cannot verify your home school status and will not be able to accept your
submission of completing classroom driver education.
Who will have access to the requested information?
DPS may disclose personal information when it relates to the operation or use of a vehicle or to public safety. The
use of personal information relates to public safety if it concerns the physical safety or security of drivers, vehicles,
pedestrians, or property. Information on an individual provided to verify home school status may be treated as
provided by 18 U.S.C. § 2721 and the Minnesota Government Data Practices Act, Minn. Stat. Ch. 13 and is subject
to the disclosure in accordance with these laws.
I consent to the verification of the above-mentioned student’s home school status with the above-mentioned resident
school district by telephone or other electronic means. I acknowledge that making false statements in this document
is unlawful and is subject to sanctions pursuant to Minn. Stat. §§ 171.17,
171.22
and other relevant laws.
Date:
Parent’s Signature
For office use only:
Date processed:
Approved by:
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PS33135-06 (12/2020)
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