Form PS31924 template
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Request for Examination of Driver
This document is a request for driver re-examination based on an incident report. The document includes personal information of the driver such as name, address, date of birth, and license number. It also details the incident including location, presence of an accident, and whether a citation was issued. The driver is suspected of having various issues leading to the incident, including physical/health problems, mental or emotional issues, and violation of alcohol/drug restrictions. The document includes a checklist for the driver to fill out and submit to the Driver Evaluation Unit in Minnesota.
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