- Form MV-901D - Garageman's Certification and Bill of Sale - New York
- Form DTF-806 - Application for Refund or Credit of Sales - New York
- Form MV-349.1 - Affidavit for Transfer of Motor Vehicle - New York
- Form MV-529A - Equipment Required for Commercial Vehicles - New York
- Form ID-82 - Proofs of Identity for Registration and Title - New York
- Form MV-456 - Certification of Disposition of Vehicle on Behalf of Absentee Owner - New York
Fillable Printable Form MV-901D - Garageman's Certification and Bill of Sale - New York
Fillable Printable Form MV-901D - Garageman's Certification and Bill of Sale - New York
Form MV-901D - Garageman's Certification and Bill of Sale - New York
Business Name:___________________________________________________ Facility # ___________________
Business Address:_______________________________________________________ Apt./STE# ____________
City:__________________________________________ State: ___________ Zip Code_______________
New York State Department of Motor Vehicles
GARAGEMAN’S CERTIFICATION AND BILL OF SALE FOR
VEHICLES WORTH LESS THAN $500.00
DISPOSAL OF LAWFULLY TOWED AND/OR STORED VEHICLES UNDER LIEN LAW, SECTION 202
(This form is also available to download from the DMV website: www.dmv.ny.gov)
I further certify that: the Date of Sale is not (a) prior to thirty days after the date on which Service of Notice was mailed, or (b) prior to sixty days after the
date of the initial tow, whichever is later; no action was brought under Section 201-a of the Lien Law, or, an action was brought and the determination was
in my (our) favor; and the required Notice of Lien was sent to owner(s) and lienholder(s). Proof of certified mailing is attached.
MV-901D (5/11)
GARAGEMAN’S/REPRESENTATIVE’S SIGNATURE - Please sign name in full DATE
GARAGEMAN’S/REPRESENTATIVE’S NAME - Print
Lienholders (Attach additional sheet, if necessary)
Business Name:_______________________________________________
Business
Address:______________________________________ Apt./STE# ______
City:__________________________ State: ______ Zip Code__________
Business Name:________________________________________________
Business
Address:______________________________________ Apt./STE# ______
City:__________________________ State: ______ Zip Code__________
GARAGEMAN’S/REPRESENTATIVE’S TITLE
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NOTICE: THE VEHICLE DESCRIBED HEREIN MAY NEVER BE TITLED AGAIN. IT MUST BE DISMANTLED OR SCRAPPED.
AFTER COMPLETION, PLEASE SUBMIT THIS FORM TO THE VEHICLE DISMANTLER OR SCRAP PROCESSOR.
IMPORTANT INFORMATION REGARDING THESE REQUIREMENTS CAN BE FOUND ON FORM MV-901DI.
To knowingly make a false statement or conceal a material fact in this statement is a criminal offense punishable under Section 210.45 of the
Penal Law, and Section 392 of the Vehicle and Traffic Law.
I, the undersigned GARAGEMAN, certify under penalty of perjury as follows (if signing as an authorized representative of a business organization,
such as a corporation, I certify that I possess the personal knowledge to make such certification and I am duly authorized to so certify on behalf of the
business): (1) the undersigned currently holds a valid, perfected Garageman’s Lien on the motor vehicle described herein; (2) such lien represents
accrued and unpaid towing and/or storage charges which remain unpaid to date; (3) the subject vehicle currently has a wholesale value of less than
$500, as indicated by the nationally recognized source checked below; and (4) the undersigned sold this vehicle to the vehicle dismantler or scrap
processor named herein.
8.
7.
6.
Vehicle Dismantler or Scrap Processor
:
Description of Vehicle (a statement of acquisition must be attached [see MV-901DI]):
Government Issued ID for
representative of vehicle dismantler
or scrap processor (copy must be
attached):
No.:_________________________
4.
Prior Owner (a copy of verification of prior owner and other lienholders must be attached):
Name: ___________________________________________________________________________________________________________________
Street
Address:______________________________________ Apt./STE# ______City:__________________________ State: ______ Zip Code___________
5.
1.
Date Vehicle was Towed :
(Towing authorization must be attached)
Service of Notice and Towing and/or Storage Information (a copy of the Notice of Lien and Sale, and a copy of receipt for mailing must be
attached [see MV-901DI]):
Date of Service of Notice to Owner: _______/_______/_______ Date of Service of Notice to Lienholder(s): ______/_______/_______
______ / _______ / ________ ______ / _______ / ________ ______ / _______ / ________
9.
Date Storage Began:
10
Date of Sale:
Year: _______ Make: ________________________ Model: ________________________ Plate Number: ___________________ State: ________
Vehicle Identification Number:
(attach photo or tracing) ____________________________________________ Wholesale Value of Vehicle: $ _________________________
Garageman (a copy of proof of business must be attached [see MV-901DI]):
Business Name:___________________________________________________ Facility # ___________________
Business Address:______________________________________________________ Apt./STE# ____________
City:__________________________________________ State: ___________ Zip Code ______________
Government Issued ID for person
submitting this form (copy must be
attached):
No.:_________________________
3.
Source of Wholesale Value
relied upon by the undersigned:
£ NADA £ Kelly Blue Book £ Other (please describe)_________________________________________
2.
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