Fillable Printable Form VS-1075.3 - Requisition for Miscellaneous Forms - New York

Form VS-1075.3 - Requisition for Miscellaneous Forms - New York

REQUISITION FOR MISCELLANEOUS FORMS

Bureau of Consumer and Facility Services

PO Box 2700

Albany NY 12220-0700

FORM NO.

VS-18

Statement That A Historical Registered Vehicle Will Be Used During Daylight Hours Only

Notice of Missing or Mutilated Vehicle Identification No.

Vehicle Inspection Record - Safety

Inspection Rejection/Advisory Notice

Requisition for Miscellaneous Forms

Diesel Emissions Inspection Certification and Waiver Form

Proof of HDDV Repair

VS-110*

VS-1074S

Vehicle Inspection Record - Heavy Vehicle Safety & Diesel EmissionsVS-1074SD

Vehicle Inspection Record - Motorcycle SafetyVS-1074M

VS-1075*

VS-1075.3

VS-1079DE

VS-1080R

NAME OF FORM

QUANTITY

REQUESTED

* These forms are bound in pads of 100 sheets per pad. Order by number of pads needed.

PLEASE TYPE OR PRINT LEGIBLY AND INCLUDE YOUR SEVEN-DIGIT FACILITY NUMBER. WE WILL NOT PROCESS

YOUR ORDER WITHOUT IT.

IMPORTANT:

l Please mail this requisition separately.

l Do not attach it to any other forms before mailing.

l Allow 3-4 weeks for delivery.

VS-1075.3 (9/15)

www.dmv.ny.gov

Date:

Address

Name of Official

Inspection Station

City

State Zip Code

Facility ID

Number

September 11, 2015

reset/clear