Name at the time of testing (if different): ______________________________________________________
Name: __________________________________________________________________________________
Date of Birth: ___________________________ Last four digits of your Social Security Number: __________
Approximate month and year tested: __________________________________ ________________________
Where tested (center / city name): ____________________________________________________________
Contact numbers (in case we have questions about your request/records):
Home: _____________________ Cell: ______________________ Work: ______________________
Name: __________________________________________________________________________________
Address: _________________________________________________________________________________
City: ______________ ____________________________ State: __________ Zip: _____________________
: ________________________________________________________________________
General Educational Development (GED) Records Request
To obtain GED records earned in Minnesota please supply the information required below. There is no charge
for the service at this time. Requests for records are mailed out within two working days of receipt of the
written request and take three days to arrive in the mail. GED records will not be faxed or emailed.
NOTE: Only one duplicate diploma is allowed for each Minnesota graduate per lifetime.
PLEASE TYPE OR PRINT LEGIBLY
What information are you requesting: _______Duplicate diploma ______ Official Transcript/scores earned
Where should we mail your records?
Signature (required)
Send requests using any of these metho ds:
Mail to: GED Office, 1500 Highway 36 West, Roseville, MN 55113‐4266
Fax: 651‐582‐8458
E‐mail a scanned signed copy (as an attachment): alice.smith@state.mn.us
GED Testing Office phone: 651‐582‐8445 TTY: 651‐582‐8201 Website: education.state.mn.us
click to sign
signature
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