Fillable Printable Form MV-522.1 - Application for Access to DMV Internet Road Test Scheduling System - New York

Form MV-522.1 - Application for Access to DMV Internet Road Test Scheduling System - New York

New York State Department of Motor Vehicles

APPLICATION FOR ACCESS TO DMV INTERNET

ROAD TEST SCHEDULING SYSTEM

www.nysdmv.com

Please complete the following:

AGREEMENT

Send this completed form to:

NYS Department of Motor Vehicles

Bureau of Driver Training Programs

Certification & Oversight Unit, Room 412

6 Empire State Plaza

Albany, New York 12228

I understand that access to the DMV internet Road Test Scheduling System is a privilege that may be suspended or

revoked by the DMV for any inappropriate use of the system or for any violation of the Commissioner’s Regulations

deemed serious by the DMV Driver Program Regulation-Customer Service Unit or RTSS System Administrator.

(Please note: Only driving school owner(s), corporate officer(s) or employee(s) registered with the department may

be authorized to use this system. To register employees, a Personal History form (MV-521.1) must be completed).

(Print name of owner/principle of Driving School)

Driving School Name

Address

Phone Number

Primary User(s):

City

E-Mail Address (Your e-mail address is required

. It can be a maximum of 50 characters)

Password (Your password should be 6 to 8 characters and may be changed if necessary)

State Zip Code

Driving School License #

MV-522.1 (7/08)

(Signature of owner/principle of Driving School)

(Date)

reset/clear