Fillable Printable Form MV-82ITP - In-Transit Permit/Title Application - New York

Form MV-82ITP - In-Transit Permit/Title Application - New York

oGas oDiesel oElectric oFlex oCNG oPropane oNoneoOther ________

Title

OFFICE

USE

ONLY

COMPLETE and . WHEN AND APPLY, COMPLETE THOSE SECTIONS. PLEASE PRINT CLEARLY.

Year Make

Color

Unladen Weight

Cylinders

Maximum Gross Weight

Does the ODOMETER display 5, 6 or 7

numbers? (write the number, do not

include tenths)

For trailers & commercial vehicles

For rentals,buses & taxis

VEHICLE DESCRIPTION

Body Type For Cars (mark one)

Body Type For Other Vehicles (mark one)

Type of Power or Fuel (mark one)

VEHICLE IDENTIFICATION NUMBER

Odometer Reading in Miles

Lien

Number

L.R.

Mileage Brand

Axles

Distance

Prior

Owner

Special Conditions:

Sales Tax

Information

Proof Submitted (Name and Ownership)

Reg/Title No._________________________________________ State_______________

EX GI IF NF NU OD OV PA RC SA SO SP SS SV

New York State Department of Motor Vehicles

IN-TRANSIT PERMIT/TITLE APPLICATION

1 2 4 6 7

USE

ONLY

DEALER

ONLY

Old Class

Old Plate

3 of Name

Insurance Company

Code

Status Value

($)

Jurisdiction Rate Out of State Audit

New

Plate

Scofflaw Case

Number(s)

New

Class ITP

Stop/Response

Operator

Approved

Date Old

Fee

PAGE 1 OF 2

o Orig

Batch

File No.

o Activity

Seating Capacity

MV-82ITP (12/13)

Station Wagon or

o 2-Door o 4-Door o Convertible o Suburban oOther______________

oPick-up oVan oMotorcycle oTow oTruck oTrailer oOther _______

INSTRUCTIONS è

PLEASE PRINT CLEARLY

Permit

Info.

Facility ID

Number

Is there a lienholder?

o Yes o No

If “Yes”, enter the information below UNLESS the

vehicle will be transported out-of-state (in that case,

advise the lender to perfect the lien in that state).

Permit

Number

Expiration Date

/ /

Date Issued

/ /

Lienholder Name and Mailing Address

Lien Filing Code

(Assigned by DMV)

Mark the box

for the action

you need.

o Transport this vehicle to register it at a location outside of New York State.

THE FOLLOWING OPTIONS CANNOT BE USED BY PLATE ISSUANCE DEALERS OR PARTNERS:

o Transport this vehicle within New York State to register it in another part of New York State.

o Transport this vehicle to obtain the required NYS Department of Transportation or NYS Heavy Vehicle inspection (see page 2 for requirements).

o Change information on a current in-transit permit.

o This vehicle will be transported FROM (point of origin, include city and state): _______________________________________________________________________

TO (destination, include city and state or country): _________________________________________________________________

NOTE:

NOT VALID IN MASSACHUSETTS

www.dmv.ny.gov

AUTHORIZATION: The registrant described in is authorized to register the vehicle described in .

M F

The owner of the vehicle must sign this section. Proof of ownership and proof of owner’s name and

date of birth are required.

NOTE -Do not complete this section if a completed Registration Authorization (form MV-95) is attached.

Area Code

( )

How did you

get the vehicle?

(mark one)

o New o Leased New

oUsed o Leased Used

NAME CHANGE?

o YES (refer to ) o NO

ADDRESS CHANGE?

o YES o NO

Is this registration for a corporation

or partnership?

o Yes o No

NAME OF PRIMARY REGISTRANT (Last, First, Middle)

NYS driver license number of PRIMARY

SEX

ADDRESS WHERE PRIMARY REGISTRANT GETS MAIL

(Signature of owner or authorized person, and signature of co-owner if applicable) (Date)

NAME OF CURRENT OWNER (Last, First, Middle)

DAY TELEPHONE (Optional)

DRIVER LICENSE NUMBER OF OWNER

Month Day Year

DATE OF BIRTH

Month Day Year

DATE OF BIRTH

Month Day Year

Apt. No. City or Town State Zip Code County of Residence

Apt. No. City or Town State Zip Code

(Include Street Number and Name,

Rural Delivery and/or box number)

ADDRESS WHERE PRIMARY REGISTRANT RESIDES IF DIFFERENT FROM THE MAILING ADDRESS

(DO NOT GIVE A P.O. BOX.)

Apt. No. City or Town State Zip Code County

ADDRESS WHERE OWNER GETS MAIL

(Include Street Number and Name, Rural Delivery or box number. This address will be on the document.)

Area Code

( )

OWNER’S DAY PHONE NO. (Optional)

2 4

M F

NAME OF CO-REGISTRANT (Last, First, Middle)

NYS driver license number of CO-REGISTRANT

SEX

DATE OF BIRTH

Vehicle Inspection Information

This information is needed to make sure you have all required proofs when you register the vehicle in New York State.

1. Read the information above to determine if a NYS DOT inspection or a NYS Heavy Vehicle inspection is required. If one of these inspections is

required, mark this box . . . . . . . .

2. I certify that, to the best of my knowledge, this vehicle o has been or o has not been wrecked, destroyed or damaged to such an extent that the

total estimate, or actual cost, of parts and labor to rebuild or reconstruct the vehicle to the condition it was in before an accident, and for legal operation

on the road or highways, is more than 75% of the retail value of the vehicle at the time of loss. (

If you mark the “has been” box, the vehicle

must have an anti-theft examination before the vehicle can be registered, and “Rebuilt Salvage: NY” will be printed on the title.)

3. Does the vehicle require a commercial operating authority permit? o Yes o No

If “Yes”, write the o NYS DOT Permit No. _________________________

o I.C.C. Permit No. ____________________________

4. Is the vehicle used as an ambulette? o Yes o No If “Yes”, mark this box if payment is received to carry passengers o

CERTIFICATION: The information I have given on this application is true to the best of my knowledge. I certify that the vehicle is fully equipped as required by

the Vehicle and Traffic Law, and has passed the required New York State inspection within the past 12 months, or has qualified for a time extension (Form VS-1077)

and will be inspected within 10 days. I also certify that appropriate insurance coverage is in effect, and that the vehicle will be operated in accordance with the

Vehicle and Traffic Law. If I am applying for replacement registration items, I certify that the registration is not currently under suspension or revocation.

If I am

using a credit card for payment of any fees in connection with this application, I understand that my signature below also authorizes use of my credit

card.

Lien Filing Code

(Assigned by DMV) _____________________________________ Lienholder Name____________________________________________________________________

Mailing Address _____________________________________________________________________________________________________________________________

(Number and Street) (City) (State) (Zip Code)

Lien Filing Code

(Assigned by DMV) ________________________________ Lienholder Name ________________________________________________________________

Mailing Address

______________________________________________________________________________________________________________________________

(Number and Street) (City) (State) (Zip Code)

To Be Completed by a Registered New York State Dealer Only – List any additional Lienholders

MV-82ITP (12/13)

DEALER CERTIFICATION: I certify that all information provided on this application is

true. I take responsibility for the integrity of the papers delivered to the Motor Vehicles office.

__________________________________________________

(Signature of Dealer or Authorized Representative)

PAGE 2 OF 2

(Sign Name in Full -Additional signature required for a partnership or if registering this vehicle in more than one name.)

(Print Name in Full - if registering for a corporation, print your full name and title)

CREDIT CARD AUTHORIZATION IF CARDHOLDER IS NOT THE APPLICANT:

My signature authorizes __________________________________________

to use my credit card for payment of any fees in connection with this application,

and I understand that I must be present for this transaction.

IMPORTANT: Making a false statement in any registration application or in any proof or statements in connection with it, or deceiving or substituting in

connection with this application, is a misdemeanor under Section 392 of the Vehicle and Traffic Law, and may also result in the revocation or suspension of

the registration pursuant to regulations established by the Commissioner. The Department makes no representation that it will issue a certificate of title or

transferable registration until the Commissioner is satisfied that the applicant is entitled to a certificate of title or transferable registration, and until all

documentation required to establish ownership of the vehicle is submitted and deemed to be satisfactory. Pending review of this application, neither the

Commissioner of the Department of Motor Vehicles nor any of his or her employees, deputies or agents assumes any liability or responsibility for repairs

performed, improvements made or work done to the vehicle referenced in this application.

Additional Signature Sign Here ç

Print Name Here ç

(Sign Name in Full)

Sign Here ç

(Cardholder-Sign Name in Full)

Sign

Here

Proof of NYS DOT INSPECTION or HEAVY VEHICLE INSPECTION IS REQUIRED before registration if the vehicle carries passengers AND the vehicle:

a. requires commercial operating authority;

b. is a bus with a seating capacity of 15 or more persons;

c. provides transportation under a contract with a private school or school district;

d. transports children under the age of 21 to places of: academic or vocational instruction through grade 12; religious services, religious instruction or both;

day camps or day care centers; care or training of persons with a physical disability, mental disability, or both;

Proof of NYS DOT INSPECTION or HEAVY VEHICLE INSPECTION IS NOT

REQUIRED before registration if the vehicle:

e. is owned and operated by a municipality, a public authority, or a school operated by, or certified by, the Office for People With Developmental

Disabilities (OPWDD);

f. is owned by the registrant for his or her personal use, and is also used to transport children under the age of 21, without compensation, as described

in “d” above;

g. is a taxi or livery vehicle which transports children under the age of 21 as described in “d” above, without a contract or agreement for on-going services.

For more information about proof of inspection requirements, refer to Inspection Requirements for Carriers Transporting Passengers (form MV-82.1P).

NAME CHANGE: Print the former name exactly like the former name is printed on the current registration or title.

CHANGES: Describe any vehicle changes and the reasons for the changes.

CHANGES - Write new information about a current registration or title on page 1 of this form. For more information, refer to form MV-82.1

“Registering/Titling a Vehicle in New York State”.