Transcription of MINNESOTA DEPARTMENT OF PUBLIC SAFETY DRIVER AND …
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PS33203-06 (03/2021)Name (First, Middle, Last)Date of Birth (mm/dd/yyyy) MINNESOTA DRIVER 's License Number:Drivers who check Category 1 or Category 3 below must also submit a current medical examiner's certificate from a certified medical examiner and any applicable certify my commercial operating status is--check only one category box below:1. Are you submitting a copy of your medical examiner's certificate from a certified medical examiner?2. Are you submitting a copy of a medical waiver?YesNoYesNoAll CDL holders with a school bus endorsement MUST submit a current medical examiner's certificate from a certified medical commercial DRIVER 's license (CDL) holders, Class A, B or C, must complete and submit this self-certification form for initial, renewal or change in class application.
MINNESOTA DEPARTMENT OF PUBLIC SAFETY . DRIVER AND VEHICLE SERVICES. Instructions: (Current medical examiner's certificate from a certified medical examiner. must. be submitted.) (Current medical examiner's certificate from a certified medical examiner. must. be submitted.) Category 1 - Non-exempt Interstate, subject to 49 C.F.R. § 391 ...
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