Fillable Printable School Bus Pre App
Fillable Printable School Bus Pre App
School Bus Pre App
SCHOOLBUSCRIMINALRECORDSCHECKAUTHORIZATION
STATE OF MINNESOTA
MINNESOTA DEPARTMENT OF PUBLIC SAFETY
Before issuing a school bus endorsement, the Commissioner of Public Safety is required to conduct a criminal records
check of the applicant (Minnesota Statutes, § 171.321, Subd. 3). The criminal records check will be conducted by the
Minnesota Bureau of Criminal Apprehension (BCA).
If you have resided in Minnesota for less than five years, the check will also include a national criminal records
check conducted by the FBI. The criminal records check by the FBI will take additional time, which could delay
the application process. You must contact the Department of Public Safety to obtain the procedures to begin the
FBI national criminal records check and the current price for the check. There is no additional fee associated with
the BCA check; however, there is an additional fee to conduct the FBI check.
The Department of Public Safety will notify you in writing of the results of the criminal records check(s). The Department
will use the criminal background criteria set forth in Minnesota Statues, §171.3215, when issuing or denying an
application for a school bus driver’s endorsement. The results of the criminal records check will not be released to anyone
but the Department of Public Safety and you. The failure to cooperate with the department in conducting the criminal
records check is reasonable cause to deny your application.
If you have any questions please call (651) 297-5029, or TDD (651) 282-6555 or write to:
Department of Public Safety, Commercial Driver License Unit, 445 Minnesota St., Suite 180, St. Paul, MN 55101-5180.
Please email this form to: [email protected]
Or, fax to: (651) 282-2110 or mail to the above address
“I, the applicant, authorize the Department of Public Safety to conduct a check of my criminal history as required by
Minnesota Statutes, §171.321, Subd. 3.”
PS33110-12 (11/15)
APPLICANT
Applicant's Full Name (please print or type)
Applicant's Maiden Name, Previous Name(s) Used
Applicant's Street Address
Applicant's City, State, Zip code
Applicant's Driver's License Number
Applicant's Date of Birth
Name of Prospective Employer
Prospective Employer's Street Address
Prospective Employer's City, State, Zip code
Contact Person of Prospective Employer
Contact Person's Phone Number
PROSPECTIVE EMPLOYER
Applicant's SignatureAuthorized Signature of Prospective Employer
