Fillable Printable Form VS-94 - Public Emissions Inspection Waitlist Application - New York

Form VS-94 - Public Emissions Inspection Waitlist Application - New York

PUBLIC EMISSIONS INSPECTION

WAITLIST APPLICATION

VS-94 (3/15)

This application only applies to public official emissions inspection stations that inspect

group 1a vehicles for the general public. It does not apply to fleet or dealer-only group 1a stations,

or to any group 2 or group 3 stations.

All applications or written requests received for public emissions inspection stations in counties which

are capped will be placed on the waitlist.

Submit one application for EACH county that you are applying for.

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£ I am already on the waitlist and information is being updated.

Complete the fields below (*denotes a required field):

Business name (if applicable):________________________________________________________

Contact person*:___________________________________________________________________

Contact mailing address*:____________________________________________________________

____________________________________________________________

Contact phone*: (______) _______-__________ Alternate phone: (______) _______-___________

Contact email:_____________________________________________________________________

County in which you want to conduct business*:__________________________________________

Current facility number (if applicable):___________________________________________________

IMPORTANT:

It is the applicant’s responsibility to update their contact information when necessary.

If you cannot be reached via the information provided above, you will forfeit your spot

on the waitlist.

via mail:

Vehicle Safety Services

Application Unit

6 Empire State Plaza, Room 220

Albany, NY 12228-0001

via fax:

(518) 474-4702

To submit this application:

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