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Fillable Printable Vehicle Registration/Title Application - New York

Fillable Printable Vehicle Registration/Title Application - New York

Vehicle Registration/Title Application - New York

Vehicle Registration/Title Application - New York

oRENEW a RegistrationoCHANGE a Registration (refer to )oREPLACE lost registration itemsoTRANSFER a Plate Number oPurchased my LEASED VEHICLE
You can update the address on your registration and renew your registration online at www.dmv.ny.gov.
oA FIRST REGISTRATION for this vehicle oCHANGE a title (refer to )oREGISTER a vehicle that I registered before
oGasoDiesel oElectric oFlexoCNG oPropaneoNone
Issuance
State
Title
AUTHORIZATION: The registrant described in is authorized to register the vehicle described in .
OFFICE
USE
ONLY
M F
oo
COMPLETE and . WHEN AND APPLY, COMPLETE THOSE SECTIONS.
Year Make
Color
Unladen Weight
Cylinders
Did you issue plates to this
vehicle?
oYesoNo
Plate
Number
Reg. Class
The owner of the vehicle must sign this section.
NOTE: Do not complete this section if a completed Registration Authorization (form MV-95) is
attached or if you apply to renew a vehicle registration and the owner of that vehicle has not
changed. Proof of ownership and proof of owner’s name and date of birth are required.
Area Code
( )
Maximum Gross Weight
oNew
oUsed
Does the ODOMETER display 5, 6 or 7
numbers? (write the number, do not
include tenths)
NAME CHANGE?
oYES (refer to ) oNO
ADDRESS CHANGE?
oYES oNO
Is this registration for a corporation
or partnership?
oYes oNo
NAME OF PRIMARY REGISTRANT (Last, First, Middle)
NYS driver license number of PRIMARY
SEX
THE ADDRESS WHERE PRIMARY REGISTRANT GETS MAIL
For trailers & commercial vehicles
For commercial vehicles
For rentals,buses & taxis
VEHICLE DESCRIPTION
Body Type For Cars (mark one)
Body Type For Other Vehicles (mark one)
(Signature of owner or authorized person, and signature of co-owner if applicable) (Date)
Type of Power (Fuel)
VEHICLE IDENTIFICATION NUMBER
NAME OF CURRENT OWNER (Last, First, Middle)
Odometer Reading in Miles
DAY TELEPHONE (Optional)
DRIVER LICENSE NUMBER OF OWNER
Month Day Year
DATE OF BIRTH
Month Day Year
DATE OF BIRTH
Month Day Year
Lien Lien
Number
Lien Release
Mileage Brand
Axles
Distance
Prior
Owner
Lienholder Name and
Mailing Address
Special
Conditions
Sales Tax
Information
Proof Submitted (Name and Ownership)
Reg/Title ______________________________________________________ State_______________
AT BV CF CO CP EX FL GI IF MO NE NF NR NU OD OP OV PA
PC PK RC RE SA SO SR SS SV TE TL TO TP TR TX XR X6 WO
Date Temp IssuedFacility ID Number
Is there a lienholder? oYes oNo If “Yes”,
enter the information in Dealer Only box below.
Lien Filing Code
(Assigned
by DMV)
Apt. No.City or TownStateZip CodeCounty of Residence
Apt. No.City or TownStateZip Code
(Include the Street Number and Name,
Rural Delivery or box number)
If you mark one of the options below, write the PLATE NUMBER here
VEHICLE REGISTRATION/TITLE
APPLICATION
This form is available at www.dmv.ny.gov
MARK THE BOX OF THE TYPE OF SERVICE YOU NEED. (For more information, refer to form MV-82.1,“Registering/Titling a Vehicle in New York State”.)
THE ADDRESS WHERE PRIMARY REGISTRANT RESIDES IF DIFFERENT FROM THE MAILING ADDRESS
.
(DO NOT GIVE A P.O. BOX.)
Apt. No.City or TownStateZip CodeCounty
THE ADDRESS WHERE OWNER GETS MAIL
(Include Street Number and Name, Rural Delivery or box number. This address will be on the document.)
Area Code
( )
DAY TELEPHONE NUMBER OF
OWNER. (Optional)
oOrig
oDup
oLease Buyout
oSales Tax with Title
oRenewal
oRenew W/RR
2
4
12467
USE
ONLY
O
F
F
I
C
E
NY
DEALER
ONLY
Old
Class
Old
Plate
3 of
Name
Ins. Co.
Code
Exp.
Date
StatusValue
($)
JurisdictionRateOut of StateAudit
New
Plate
Scofflaw Case
Number(s)
New
Class
Stop/Response
Operator
Approved
By
Date Old
Fee
Batch
File No.
PAGE 1 OF 2
MV-82 (6/15)
oActivity
oActivity W/RR
NY
DEALER
ONLY
Seating Capacity
1
3
3
5
Alterations are not allowed in the lienholder sections.
Station Wagon or
o2-Door o4-Door oConvertible oSuburbanoOther______________
ooVan oMotorcycle ooTrailer oOther _______________
INSTRUCTIONS è
5
5
5
24
PRINT CLEARLY IN
BLUE OR BLACK INK.
M F
oo
NAME OF CO-REGISTRANT (Last, First, Middle)
NYS driver license number of CO-REGISTRANT
SEX
DATE OF BIRTH
Get a TITLE ONLY for a 1973
or newer vehicle
o
How did you get
the vehicle?
(mark one)
Pick-up
Truck
Tow
Truck
oLeased New
oLeased Used
1. I certify that, to the best of of my knowledge, this vehicle ohas been or ohas 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.(Checking the “has been
” box means the
vehicle must have an anti-theft examination before being registered, and that the title issued will have the statement “Rebuilt Salvage” on it.)
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.
ADDITIONAL VEHICLE INFORMATION QUESTIONS 1-3 MUST BE COMPLETED.
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 have plates in a series reserved for a special group, I certify that I am still eligible to receive them, and that I have
only one set of these plates. 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-82 (6/15)
NY 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)
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”.)
PAGE 2 OF 2
(Sign Here - 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
My signature authorizes __________________________________________
to use my credit card for payment of fees in connection with this application,
and I understa
nd that I must be present for this transaction.
CREDIT CARD AUTHORIZATION IF CARDHOLDER IS NOT THE APPLICANT:
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 Hereç
(Print Name in Full)
Print Additional
Name Hereç
(Sign Here)
Sign Hereç
(Cardholder-Sign Name in Full)
Sign
Here
5
4.This vehicle is a pick-up truck with an unladen weight that is a maximum of 6,000 pounds. This vehicle is never used for commercial
purposes and does not have advertising on any part of it. I want (mark one):
3. Has this vehicle been modified to change its registration class?
oYes oNo If “Yes”, explain _____________________________________
_______________________________________________________________________________________________________________________
2. Is this vehicle registered for your personal use?
oYes oNo
If you marked “Yes”, go to the next question (question 3) . If you marked “No”, check any of these boxes that apply:
oThis vehicle is a passenger vehicle that will be used for hire with a driver and will be operated in the following location(s):
oNew York City (NYC) oA jurisdiction that is not NYC that regulates taxis oA jurisdiction that does not regulate taxis
oThis vehicle is a passenger vehicle that is rented without a driver.
oThis vehicle requires a permit for commercial operation. (Mark the box of the type of permit that was issued and write the permit number on the line.)
oNYS DOT Permit No. _________________ oFederal DOT Permit No. _________________
oThe government owns this vehicle.
oThis vehicle is used as (mark one) oan ambulanceoan ambuletteoa hearse or invalid coach
If payment is received to carry passengers, mark this box.o
oThis vehicle is used exclusively as a hearseIf payment is received to carry passengers, mark this box.o
oThis vehicle is a commercial tow truck with a gross vehicle weight rating of at least 8,600 pounds.
oThis vehicle is used only as a farm vehicle. (form MV-260F, Part 1, must be attached) oThis vehicle is used only as an agricultural truck.
oThis vehicle is subject to the Department of Transportation inspection requirements for the carriers that transport passengers. (For more
information, refer to form MV-82.1P, “Inspection Requirements for Carriers Transporting Passengers”.)
ç
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oPassenger Plates oCommercial Plates
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