Decal Order Form PDF Details

In the realm of vehicle safety and regulation, the Minnesota Department of Public Safety – State Patrol Division's Mandatory Inspection Program Decal Order Form serves as a critical tool. This document outlines the procedures and requirements for obtaining decals, which are essential for vehicles that have passed the mandated inspections. Designed to ensure compliance and promote safety on the roads, the form requires detailed information from applicants, including their name, mailing address, telephone number, and company details. With decals available for the current and preceding year, and the next year’s decals becoming available each December 1, meticulous attention to ordering the correct year and quantity is advised, as decals are non-refundable and non-exchangeable, priced at $2.00 each. Payment instructions are clear, with checks made payable to the STATE OF MINNESOTA and specific mailing directions. For those opting to pay by credit card, a service charge is applied, underscoring the form's emphasis on security by disallowing email or fax orders. The Decal Order Form also binds the inspector to a critical compliance agreement: placing decals solely on vehicles that meet legal inspection standards, with the caveat that misuse may result in revoked inspection privileges. This agreement ensures that decals serve their intended purpose – as marks of safety and regulatory compliance. Furthermore, the form includes sections for inspector certification number, signature, and the transaction details, highlighting the structured approach to maintaining integrity in the vehicle inspection process.

QuestionAnswer
Form NameDecal Order Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesminnesota mandatory inspection program decal order form, mn dot inspection decal forms, minnesota dot decal order form, minnesota mandatory inspection decal order form

Form Preview Example

Minnesota Department of Public Safety – State Patrol Division

MANDATORY INSPECTION PROGRAM DECAL ORDER FORM

Fill out information to the right.

Please type or print your name and mailing address legibly. Please provide unattached return label(s).

Company Telephone Number

Company Name

Mailing Address

City

State

Zip Code

Decals are available for the current year and one preceding year. Decals for the following year will be available beginning December 1. Decals are not refundable or

exchangeable. Please order carefully. Decals are $2.00 each. What year decals do you want to purchase?

How many decals do you want to purchase?

Total due for decals $

(Do not include credit card fee.)

Make check payable to STATE OF MINNESOTA. (Please do not attach check stub or staple to orders)

Mail order form and remittance to: MN State Patrol Commercial Vehicle Section 1110 Centre Pointe Curve #410

Mendota Heights, MN 55120

If you have any questions about the decal order, please call the Minnesota State Patrol at (651)350-2000.

Credit Card Orders: For your security, we do not accept credit card orders by e-mail or fax. Please mail your order to the above address. A service charge of $4.50 is assessed for each credit card order. On Orders for multiple inspectors - the card number only needs to be entered on the top form.

Credit Card Number

Month/Year

•It is hereby agreed this inspector will recognize the critical criteria established by the State Patrol Division of the Department of Public Safety, and shall place decals only upon vehicles that have passed inspection as provided by law.

•Should it ever be determined this inspector has issued decals without regard to all provisions set forth in 49 CFR 396.17 and MS 169.781, the privileges of performing certified inspections may be revoked.

•Decals listed below are to be used only by the inspector who has signed this form. Use by any other person is strictly prohibited.

Agreed by:

Certified Inspector’s Signature

Date

Inspector Certification Number

Print Inspector Name

 

Company Name

 

 

 

 

 

 

 

For Office Use Only

 

Beginning Decal #

 

Ending Decal #

 

Transaction Type: CC_____ Check_____ Cash_____

 

Date Issued

Issued by

(Revised 12/28/2020)

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Writing section 1 in mn mandatory inspectionpr ogram decal orderf orm

2. Immediately after the previous part is filled out, go to enter the applicable details in all these: Credit Card Orders For your, Credit Card Number, MonthYear, It is hereby agreed this inspector, Decals listed below are to be, Agreed by, Certified Inspectors Signature, Date, Inspector Certification Number, Print Inspector Name, Company Name, Beginning Decal, Ending Decal, For Office Use Only, and Transaction Type CC Check Cash.

Filling out segment 2 in mn mandatory inspectionpr ogram decal orderf orm

People generally make some mistakes while filling in Agreed by in this section. Be sure to read again what you enter right here.

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