Fillable Printable Dl Restriction Removal

Dl Restriction Removal

Restriction Removal Notification

MINNESOTA DEPARTMENT OF PUBLIC SAFETY

DRIVER AND VEHICLE SERVICES

Instructions: This form must be signed to request removal of the ‘ANY USE OF ALCOHOL OR DRUGS INVALIDATES

LICENSE’ restriction on the driver’s license and driving record after 10 years.

This form can be faxed to (651) 797-1298. You may also bring this form to any Driver Exam Station (Visit the DVS

Website for all Office Locations) or mail this form to Driver and Vehicle Services, 445 Minnesota Street, Suite 170, St.

Paul, Minnesota 55101. For questions, contact DVS at (651) 296-2025 or visit dvs.dps.mn.gov.

I, am requesting

removal of the 'Any use of alcohol or drugs invalidates license’ restriction on my driver’s license. I understand that a

background check of the past 10 years is required before removal is approved. If the background check is returned without a

reference to alcohol consumption, use or possession of a controlled substance, you will be notified to apply for a duplicate or

renewal driver license to have the restriction removed.

Signature

- - - -

Driver's License Number

Date of Birth

City/State/Zip

Address

Daytime Phone Number

Date

PS2122-02 05/12

(First Name)

(Middle Name) (Last Name)

(First Name) (Middle Name) (Last Name)

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