Get Mn Pre-license Course Exam Proctor Affidavit Student/licensee Name And Certification 2014-2025

Filling out the MN Pre-License Course EXAM Proctor Affidavit Student/Licensee Name And Certification is an essential step in your licensing process. This guide will walk you through each section of the form, ensuring you provide accurate and complete information in an online format.

Follow the steps to complete the form accurately.

1. Click the 'Get Form' button to obtain the form and access it in an online editor.
2. Enter the name of the exam you have completed in the designated field labeled 'Name of Exam'.
3. Fill in the 'Date & Time of Exam Completion' to document when you finished the exam.
4. Provide the company name and address where the exam took place. Be sure to fill in the city, state, and zip code.
5. In the section for Student’s Full Legal Name, write your full legal name, license number, and date of birth, ensuring that the information is written legibly.
6. Complete your business address, providing the relevant city, state, and zip code details.
7. If your mailing address is different from your business address, fill in the mailing address section accordingly, along with the city, state, and zip code.
8. Provide your daytime phone number and email address in the appropriate fields.
9. Sign the document in the designated area under 'Student Signature' and indicate the date of signing, ensuring it matches the exam date.
10. Enter the Proctor's full legal name. Again, ensure this is printed or typed legibly.
11. Note any relationship to the student or prospective employer or sponsoring organization in the relevant space.
12. The proctor must certify their status as a disinterested third party, confirming they did not have a conflict of interest, and verify the student's identity during the exam.
13. Have the proctor sign and date the document in the designated area, ensuring the signature matches the exam date.
14. Lastly, complete the employer and job title section, followed by the business address, city, state, and zip code.
15. Fill in the proctor's business or daytime phone number and email, ensuring all information is typed or printed clearly.
16. After completing all sections, save the form, then download, print, or share it as required.

Start filling out your MN Pre-License Course EXAM Proctor Affidavit online today!