Fillable Printable Form DTP-201 - Driver Training Programs Complaint Form - New York
Fillable Printable Form DTP-201 - Driver Training Programs Complaint Form - New York
![Form DTP-201 - Driver Training Programs Complaint Form - New York](/resources/formfile/images/fb/source_images/form-dtp-201-driver-training-programs-complaint-form-new-york-d1.png)
Form DTP-201 - Driver Training Programs Complaint Form - New York
![](/resources/formfile/htmls/fb/form-dtp-201-driver-training-programs-complaint-form-new-york/bg1.png)
Program Name
Program Address
City State Zip Code
DRIVER TRAINING PROGRAMS
COMPLAINT FORM
www.dmv.ny.gov
PROGRAM
INSTRUCTOR
Use this form to register a complaint based on your experience with a driver training program, a driver training
instructor, or both.
o Driver Education Program
o Driving School
o Point and Insurance Reduction Program Delivery Agency
o Point and Insurance Reduction Program Sponsor
o Internet or Electronic Point and Insurance Reduction Program
o Driver Education Instructor
o Driving School Instructor
o Point and Insurance Reduction Program Instructor
o Pre-licensing Instructor
Mark the box or boxes below that apply to your complaint.
DTP-201 (6/15)
PAGE 1 OF 2
BUSINESS ID NUMBER CLIENT ID NUMBER
OFFICE USE ONLY
Complete this section if your complaint is about a driver training program.
COMPLAINT ABOUT A PROGRAM
COMPLAINT ABOUT AN INSTRUCTOR
Instructor’s Last Name
Instructor’s Address
City
Complete this section if your complaint is about a driver training instructor.
Instructor’s First Name
Name of the Program, School, Delivery Agency or Program Sponsor
COMPLAINT ABOUT A DRIVER TRAINING PROGRAM, INSTRUCTOR, OR BOTH
State Zip Code
![](/resources/formfile/htmls/fb/form-dtp-201-driver-training-programs-complaint-form-new-york/bg2.png)
Your M.I.
Your First Name
Mail or fax this ORIGINAL complaint form, with copies of
the documents that support your complaint, to:
New York State Department of Motor Vehicles
Driver Training Programs
6 Empire State Plaza
Albany NY 12228
Fax: (518) 473-0160
Your Signatureç
Date
PAGE 2 OF 2
DTP-201 (6/15)
Complaint Number
OFFICE USE ONLY
Your Address
Your Email Address
Write a full description of your complaint. If necessary, attach more pages.
Your Work Phone
( )
COMPLAINANT
Write the date or dates of this incident here:_____________________________________________________________
If there is a hearing to resolve this complaint, will you agree to testify?
o Yes o No
Attach the COPIES of letters or other documents that support your complaint.
If there is a hearing, I understand that the hearing will use a copy of this complaint and the other documents from me.
I understand that DMV also can provide these copies to the program or instructor named in this complaint. I understand
that this complaint and information about this complaint can be provided for a Freedom of Information (FOIL) request.
I understand that DMV will not provide any personal information about me, except my name, unless required to legally.
Your Last Name
Your Home Phone
( )
Suffix
City State Zip Code
You must complete this section. DMV does not accept anonymous complaints.
DESCRIPTION OF COMPLAINT
reset/clear