Driver's License Number
Today's DateFull Name
State CityStreet Address County Zip code
Date of Birth
MINNESOTA DEPARTMENT OF PUBLIC SAFETY
DRIVER AND VEHICLE SERVICES
445 Minnesota Street, Saint Paul, MN 55101
Phone: (651) 297-2126 TTY: (651) 282-6555 Web: dvs.dps.mn.gov
Note: Homemade trailers with a value exceeding $5,000 need original receipts.
Photos showing all four sides are required on trailers with a gross weight capacity of 6,000 pounds or greater.
Rev. 08/15
Homemade Trailer Construction
Part Obtained From Value
Wheels/Axle(s)
Box/Bed
Frame
Other
Total value of trailer:
Empty weight:
Gross weight capacity (total weight of trailer + cargo):
I agree to defend and protect the State of Minnesota against any claim of ownership which may arise at any time after this
trailer is registered in my name and a certificate of title and/or registration is issued.
X
Signature
Date
*Note: Original receipts of any parts purchased for the construction of the trailer may be submitted to reduce the amount of
sales tax paid.
Date trailer completed:
