- Form MV-285R - Student MV-285 Roster - New York
- Form MV-278.8SSC - Pre-Licensing Course Completion Certificate Order Form - New York
- Form DTP-421 - Intent to Conduct DMV's 30-Hour Basic Instructor's Course Notice - New York
- Form MV-523 - Application for Driving School Instructor Certificate - New York
- Form MV-526 - Driving School Instructor Termination Notice - New York
- Form MV-521 - Driving School License Application - New York
Fillable Printable Form MV-2786 - Authorized Signature List - New York
Fillable Printable Form MV-2786 - Authorized Signature List - New York
Form MV-2786 - Authorized Signature List - New York
Instructions: Refer to Part 7.8 of the Commissioner’s Regulations. All driving schools must complete this form and send it to the
Department of Motor Vehicles when applying for an original driving school license, renewing an existing license, and anytime there is a
change in the personnel who are authorized to sign in the categories listed below.
Print Name and Address of Business/School/Organization Here
In Section A below, list all
individuals who are authorized to sign. If you are filing an amended form, list in Section A only those new
individuals who are requesting approval to sign. List deletions in Section B.
List individuals authorized to:
request Pre-licensing Course Completion Certificates (MV-278).
issue Pre-licensing Course Completion Certificates.
sign duplicate certificates.
NOTE: Only classroom-endorsed instructors who teach the course may issue MV-278 certificates. Only owners, classroom-endorsed
instructors, a director of continuing education, or a school principal can be authorized to sign duplicate certificates.
Request
Books
Send completed form to: Department of Motor Vehicles
Driver Program Regulation
Driver Training Unit
6 Empire State Plaza, Room 412
Albany NY 12228
Sign
Duplicate
County ___________________________ Phone ________________________ Check One:
Driving School
Other
MV-278.6 (6/07)
AUTHORIZED SIGNATURE LIST
Pre-licensing Course
PLEASE CHECK ONE
Original
Renewal
Amended
(Date) (Signature)(Print Name) (Title)
In Section B, list all individuals whose names should be removed from the Authorized Signature List that is on file with DMV.
Put a (
) mark in the appropriate box(es) next to each signature.
Print Name Title Signature
Request
Books
Issue
Certificates
Sign
Duplicate
Print Name Title
Issue
Certificates
FOR OFFICE USE
Request approved by ____________
Office _________________________
Date __________________________
A.
B.
IMPORTANT: This form must be signed below by the chief school officer or owner.
reset/clear
