Fillable Printable Form MV-197 - Exempt Vehicle Certificate - New York

Form MV-197 - Exempt Vehicle Certificate - New York

New York State Department of Motor Vehicles

EXEMPT VEHICLE CERTIFICATE

MV-197 (11/07)

I, ______________________________________________________, affirm under penalty of perjury that the

information given below is correct, and that I am the owner of this vehicle, or an officer of the firm or corporation

registering this vehicle.

This certificate pertains to the vehicle with license plate number_________________________________.

Note: If the vehicle is not currently registered by you (and does not have a license plate on it), please provide the vehicle

identification number:

_________________________________________________________________________________.

Check the box that applies to this vehicle:

 This vehicle is an ambulance and no charge is made for services, or the cost of service is incidental to the

operation of a non-profit hospital.

 This vehicle is a bus and no charge, direct or indirect, is made for carrying any person. The vehicle has a

seating capacity of _____________ and is used follows:________________________________________

Name of Registrant (Print or Type)

Street Address

City State Zip Code

Title or position (if a firm or corporation)

Signature (See “Instructions” above) ±_____________________________________________________________

www.nysdmv.com

Apt. #

N An ambulance is exempt from an annual registration fee if no charge is made for services, or if the

cost of service is incidental to the operation of a non-profit hospital.

N You must provide a New York State Insurance Identification Card (Form FS-20) to register an

ambulance or bus if “For-Hire” insurance coverage is not required. You can obtain the required

insurance coverage and identification card from any insurance company authorized to do business in

New York State

N This certificate must be signed. If the vehicle is registered by a firm or corporation, an officer must sign

this certificate. Specify the of

ficer’s title or position in the box at the bottom of this form.

INSTRUCTIONS