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

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

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 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
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
4
1 2 4 6 7
USE
ONLY
O
F
F
I
C
E
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
By
Date Old
Fee
PAGE 1 OF 2
o Orig
Batch
File No.
o Activity
Seating Capacity
1
3
5
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
oo
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
3
5
2 4
M F
oo
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 . . . . . . . .
o
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)
6
7
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
ç
5
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”.
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