Government Forms Series 2b

 

Complete the information in the form.

Applicant's Legal Name MN Drivers License or ID #
Previous Name (if any) Home Phone #
Social Security Number I don't have one Birthday   
Eye Color Sex   
Hair Color    
Weight    
Height    
    State   
Street Address ZIP   
City County   
       
Yes No I request that my license or ID card show that I have a living will/health care directive.
   
Yes No I request that my license or ID card have a Medical Alert identifier.  I understand that the card will not contain any medical information.
   
Yes No I want my license or identification card to show that I consent to be an organ and tissue donor.
       

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GF2b1