Inspector / Mechanic Application (SHP-451X) — Missouri State Highway Patrol

Accessible Web Version. This is the WCAG 2.1 AA accessible alternative to the SHP-451X PDF form. Fill in the fields below, then use the Print Form button at the bottom of the page. You will need to physically sign the printed form and attach a 2″ × 2″ photograph (taken within the past 3 months, with your name and address on the back) before mailing or delivering to your troop headquarters.

Where to Send This Form

Mail or deliver this completed application and your photograph to the Missouri State Highway Patrol headquarters of the troop area where your place of employment is located.

Troop headquarters mailing addresses
Troop	Address
Troop A	1900 NE Independence Avenue Lee’s Summit, MO 64064
Troop B	308 Pine Crest Drive Macon, MO 63552-1030
Troop C	3180 Koch Road St. Louis, MO 63125
Troop D	3131 East Kearney Street Springfield, MO 65803-5044
Troop E	4947 Hwy 67 North Poplar Bluff, MO 63901-8719
Troop F	5621 Raptor Rd, Highway 50 W Jefferson City, MO 65109
Troop G	1226 West Business Highway 60/63 Willow Springs, MO 65793-9222
Troop H	3525 North Belt Highway St. Joseph, MO 64506-1370
Troop I	1301 Nagogami Road Rolla, MO 65401 Mailing address: PO Box 128, Rolla, MO 65402-0128

Instructions

Fill in all blocks and mark (X) in the appropriate boxes. Print information in capital letters with a pen. Attach a 2″ × 2″ photograph taken within the past 3 months (your name and address must be on the back of the photograph). Mail or deliver this completed application and your photograph to the Missouri State Highway Patrol headquarters of the troop area where your place of employment is located.

Attention new applicant: To become an inspector you must have had one year of practical experience as an automotive mechanic or have successfully completed a course of vocational instruction in automotive mechanics from a generally recognized educational institution, either public or private. Permits are not denied on the basis of sex, race, creed, color, religion, or ancestry.

Applicant’s Identification and Address

Last Name

First Name

M.I.

Permit Number

Name Suffix

None JR SR

Home Address — Street

City

State

Zip Code

Date of Birth — Month

Day

Year

Sex

M F

Home Area Code & Telephone

Social Security Number Required by Department of Revenue. Format: XXX-XX-XXXX.

Driver License Number

Emissions Certified Date

Mechanical Experience & Training

New applicants only. List all garages and EMI / mechanical schools where you received experience or training. Use additional sheets if needed.

Garages and mechanical schools where experience or training was received
Type	Name & Address (where experience / training received)	From		To
Type	Name & Address (where experience / training received)	MO	YR	MO	YR
Garages, etc.	Garage 1 — name and address	Garage 1 — from month	Garage 1 — from year	Garage 1 — to month	Garage 1 — to year
	Garage 2 — name and address	Garage 2 — from month	Garage 2 — from year	Garage 2 — to month	Garage 2 — to year
	Garage 3 — name and address	Garage 3 — from month	Garage 3 — from year	Garage 3 — to month	Garage 3 — to year
EMI / Mechanical Schools	School 1 — name and address	School 1 — from month	School 1 — from year	School 1 — to month	School 1 — to year
EMI / Mechanical Schools	School 2 — name and address	School 2 — from month	School 2 — from year	School 2 — to month	School 2 — to year

Inspection Station(s)

List your current inspection station employer(s). Use additional sheets if needed.

Current inspection station employer(s)
Name & Address of Current Inspection Station Employer	Area Code & Telephone	Station Permit No.
Station 1 — name and address	Station 1 — phone	Station 1 — permit number
Station 2 — name and address	Station 2 — phone	Station 2 — permit number

Certification

I certify that the information in this application is accurate and complete, and if approved, that I will inspect vehicles in accordance with motor vehicle safety inspection laws and prescribed rules and regulations.

Applicant’s Signature

Date Signed