Notice of disqualification is served by a peace officer when
a person is subject to disqualification under Minnesota Statutes, section
171.165,
subdivision 2.
C. A completed notice must contain the
information specified in this subpart and may contain other information
provided by the commissioner that the commissioner considers appropriate:
(1) the person's full name, date of birth,
driver's license number, height and weight, and residential address on the
driver's record, including street number, city, state, and zip code;
(2) the date the notice of disqualification
is served;
(3) the date of the
incident;
(4) the traffic case
number;
(5) the type of vehicle
being operated at the time of the incident;
(6) the name, signature, and agency name of
the peace officer serving the notice of disqualification;
(7) the reason for the
disqualification;
(8) the length of
the disqualification period;
(9) a
statement advising the person that the person is under an out-of-service order
required under Minnesota Statutes, section
169A.54,
subdivision 7, paragraph (c), for 24 hours;
(10) a statement advising the person that the
person is disqualified from operating commercial motor vehicles in seven days
or upon expiration of a seven-day temporary license period or when the
disqualification will be effective;
(11) a statement that no temporary license
was issued, if the person did not have valid driving privileges at the time of
the incident;
(12) a statement
informing the person that the person has a right to an administrative
reconsideration by the commissioner of the notice of possible disqualification
under Minnesota Statutes, section
171.166,
subdivision 3, and to a judicial review of the disqualification order under
Minnesota Statutes, section
169A.53,
subdivision 2;
(13) information
explaining that an administrative review of the disqualification order under
Minnesota Statutes, section
169A.52
or 171.65, may be obtained by submitting a written request for an
administrative review to the commissioner under part
7409.4600, subparts
1 to 4, and Minnesota
Statutes, section
169A.53,
subdivision 1, unless the person has already requested reconsideration of the
notice of possible disqualification under Minnesota Statutes, section
171.166,
subdivision 3;
(14) information
explaining that a judicial review of a disqualification order issued under
Minnesota Statutes, section
169A.52,
may be obtained by filing a petition for judicial review within 30 days of
receipt of the notice of disqualification for a violation of Minnesota
Statutes, section
169A.52.
The request must be made in accordance with Minnesota Statutes, section
169A.53,
subdivision 2; and
(15) a statement
informing the person that failing to petition for judicial review in compliance
with Minnesota Statutes, section
169A.53,
subdivision 2, forfeits the person's right to judicial review of a
disqualification order issued under Minnesota Statutes, section
169A.52.