• A $5 search fee is charged for all report requests. Checks/money orders should be made payable to:
Driver and Vehicle Services
Reports can be obtained in person or by mail at Driver and Vehicle Services, 445 Minnesota Street, St. Paul,
Minnesota 55101-5161. For questions, call (651) 215-1232.
• Requests will not be processed without a signature from an authorized requestor. An Authorized Requestor is:
Crash Information (PRINT OR TYPE):
Person(s) Involved
(first, middle, last name)
Date of Birth Driver License Number License Plate Number *
1.
2.
3.
* Without listing license plate numbers, the requested report may not be located.
Check the appropriate box:
Driver
Owner of Damaged Property
Passenger
Owner of Vehicle (if company owned,
provide name of company)
Pedestrian
Next of Kin
Legal Representative
For office use only:
Comments:
Search made - No File Located Search made - No police report available
PS2503-07 (12/14)
Name (PRINT OR TYPE)
Escrow Account Number
Escrow account holders may fax requests to: (651) 797-1244 or e-mail to: [email protected]
.
MINNESOTA DEPARTMENT OF PUBLIC SAFETY
DRIVER AND VEHICLE SERVICES
Signature of Authorized Requester
Please note: In the case of a fatality, the next of kin, or legal representative must provide proof of death, such as a death certificate,
obituary, or memorial card.
X
Mail to:
Insurance Representative
Ins. Claim #
Certification: I (we) certify that the information and statements on
this request are true and correct, and comply with the provisions of
Minn. Stat. § 169.09. I (we) understand that disclosing any
information contained in any crash report, except as provided in
Minn. Stat. §§ 169.09, Subd. 13, 13.82, Subd. 3 or 6, or other
statutes is a misdemeanor.
• a person involved with the crash (i.e. driver, passenger, owner of damaged property, owner of vehicle, or pedestrian)
• a person recorded on the police report
• an insurance representative
• a legal representative
Law Enforcement Case #
Company Name
MINNESOTA CRASH RECORD REQUEST
Location of Crash (Street or Highway) City / County Date of Crash (mm/dd/yy)
Print Form
