Fillable Printable Form VS-18 - A Historical Registered Vehicle Be Used During Daylight Only - New York

Form VS-18 - A Historical Registered Vehicle Be Used During Daylight Only - New York

THIS CERTIFICATE IS VALID ONLY FOR THE VEHICLE

DESCRIBED ON THIS FORM

(Vehicles originally equipped with a “sealed beam”, or subsequently approved, headlight system are not eligible for

this exemption.)

Instructions To Inspection Station

1. Give the motorist a blank form upon request.

2. Have the motorist fill in all the required information, and have him/her sign the “Certification”statement.

3. Inspect the vehicle according to the requirements appropriate to the particular model year of the vehicle.

4. Attach this completed form to the Motor Vehicle Inspection Record.

STATEMENT THAT A HISTORICAL REGISTERED

VEHICLE WILL BE USED DURING DAYLIGHT HOURS ONLY

Bureau of Consumer and Facility Services

CERTIFICATION: I certify that the vehicle described above was never manufactured or equipped with a sealed

beam (or subsequently approved) headlight system, and will be operated only during the period from one-half hour

before sunrise to one-half hour after sunset, when visibility for a distance of one thousand feet or more ahead of

such vehicle is clear.

__________________________________________________________________ _________________________________

See “Instructions To Inspection Station” below:

Name of Owner (Last, First Middle Name)

Current Mailing Address (Include Street Number and Name, Rural Delivery, Box and/or Apartment Number)

City or Town State Zip Code

Plate

Number

Month & Year

of Expiration

Vehicle Year

Make

Type

(Signature of Owner)

(Date)

VS-18 (9/15)