NYS_DMV_MV-82 PDF form, Free download.

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Form Name:   NYS_DMV_MV-82
Tags:   new york, dmv
Posted Date:   2/16/2010
Size:   301KB
Type:   .PDF
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CHANGEa title (see box )TITLE ONLYfor a 1973 or newer vehicleLEASE BUY-OUTPlate Number Gas Diesel Electric Flex CNG Propane NoneIssuance StateTitleAUTHORIZATION: The registrant named in box is authorized to register the vehicle described in box .OFFICEUSEONLYM FCOMPLETE BOXES and . COMPLETE BOXES AND ONLY IF NECESSARY. Year MakeColorUnladen WeightCylindersDid you issue plates to thisvehicle?YesNoPlate NumberReg. ClassIF YOU ARE NOTTHE OWNER of this vehicle, the owner must complete this section. Proof ofownership and proof of owners name and date of birth are required. NOTE-You do not have to fill in this section if you attach a completed Registration Authorization (MV-95), orif you are renewing the vehicle, and the owner is the same.Area Code( )Max. Gross Weight How was the vehicle obtained? New Leased New UsedLeased UsedVehicles ODOMETERhas roomfor how many numbers(5, 6 or 7 -do not include tenths)?NAME CHANGE? YES (see box ) NOADDRESS CHANGE?YES NOIs this registration for a corporation or partnership? Yes NoNAME OF REGISTRANT (Last, First, Middle)CLIENT ID NO.(from Driver License of first registrant listed below)SEXADDRESS WHERE YOU GET YOUR MAILFor trailers & commercial vehicles For commercial vehicles For rentals,buses & taxis VEHICLE DESCRIPTIONBody Type For Cars Body Type For Other Vehicles (Owners/Authorized Signature-Co-owners Signature if applicable) (Date)Type of Power (Fuel)VEHICLE IDENTIFICATION NUMBER NAME OF CURRENT OWNER(Last, First, Middle)Odometer Reading in MilesDAY PHONE NO. (Optional)OWNER CLIENT ID NO. (from Driver License)Month Day YearDATE OF BIRTH Month Day YearDATE OF BIRTH Lien LienNumber Lien Release Mileage BrandAxlesDistance PriorOwnerLienholder Name and Mailing AddressSpecialConditionsSales TaxInformationProof 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 IDNumberIs there a lienholder? Yes No If YesŽ, enter the information in Dealer Only box below. Lien Filing Code (Assigned by DMV)Apt. No.City or TownStateZip CodeCounty of ResidenceApt. No.City or TownStateZip Code(Include Street Number and Name, Rural Delivery and/or box number)REGISTERthis vehicle for the first timeRENEWplate # REPLACElost registration items New York State Department of Motor VehiclesVEHICLE REGISTRATION/TITLE APPLICATIONThis form is also available on DMVs web site - www.nysdmv.comWHAT DO YOU WANT TO DO? (See Form MV-82.1, Registering a Vehicle in New York State, for more information.)ADDRESS WHERE YOU LIVE (IF DIFFERENT FROM MAILING ADDRESS. DO NOT GIVE P.O. BOX.)Apt. No.City or TownStateZip CodeCountyADDRESS WHERE OWNERGETSMAIL (Include Street Number and Name, Rural Delivery and/or boxnumber. This address will appear on the document.) Area Code( )OWNERS DAY PHONE NO. (Optional)Orig Dup Lease Buyout Sales Tax with Title Renewal Renew W/RR 2412467USEONLYOFFICENYDEALERONLYOldClassOldPlate3 ofNameIns. Co.CodeExp.DateStatusValue ($)JurisdictionRateOut of StateAuditNewPlateScofflaw Case Number(s)NewClassStop/ResponseOperator Approved ByDate Old FeeBatch File No.PAGE 1 OF 2MV-82 (7/07)Activity Activity W/RRNYDEALERONLYTRANSFER Plate Number to this vehicleCHANGEregistration for Plate Number (see box )Seating Cap.1335Alterations are not allowed in the lienholder sections.MV-82 Station Wagon/2-Door 4-Door Convertible SuburbanOther______________Pick-up Van Motorcycle Tow Trailer Other _______________INSTRUCTIONS 55245PLEASE PRINT CLEARLY IN BLUE OR BLACK INK.1.I certify that, to the best of of my knowledge, this vehicle has been or has 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 beenŽ box means the vehicle must have an anti-theft examination before being registered, and that the title issued will have the statement Rebuilt SalvageŽ on it.)2.Is this vehicle registered for your own personal use? Yes NoIf YesŽ, go to question 3 below. If NoŽ, check any of the following boxes that apply:It is a passenger vehicle to be used for hire with a driver and operated in:New York City Ajurisdiction other than NYC, that regulates taxis A jurisdiction that does not regulate taxisIt is a passenger vehicle that is rented without a driver.It requires a commercial operating authoritypermit:NYSDOTPermit No. ______________I.C.C. Permit No. _____________US DOT Permit No. ____________It is government-owned.It is used as an ambulanceambulette hearse/invalid coach Check this box if: payment is received to carry passengersIt is used exclusively as a hearseCheck this box if: payment is received to carry passengersIt is a commercialtow truck with a GVWR of at least 8,600 lbs.It is used only as a farm vehicle(Form MV-260F, Part 1, must be attached).It is used only as an agricultural truck.3.Has this vehicle been modified to change its registration class? Yes No If YesŽ, explain _________________________________________________________________________________________________________________________________4.This vehicle is a pick-up truckwith an unladen weight of 5,500 pounds or less, used exclusively for non-commercial purposes, with no advertising anywhere on it, and you want? Passenger Plates Commercial PlatesNAME CHANGE: Print former name exactly as it appears on the current registration or title.CHANGES: Describe any vehicle changes and the reasons for the changes.ADDITIONAL VEHICLE INFORMATION QUESTIONS 1-3 MUSTBE 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 bythe 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 withthe 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 Ihave 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 acredit 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_____________________________________ Lienholder Name____________________________________________________________________Mailing Address_____________________________________________________________________________________________________________________________ (Number and Street) (City) (State) (Zip Code)Lien Filing Code __________________________________ 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 LienholdersMV-82 (7/07)NY DEALER CERTIFICATION:I certify that all information provided on this applicationis true. I take responsibility for the integrity of the papers delivered to the Motor Vehicles office.__________________________________________________(Signature of Dealer or Authorized Representative)CHANGES- To change information on a current registration and/or title, be sure to enter the newinformation on page 1 of this form. (See Form MV-82.1,Registering a Vehicle in New York State, for more information.)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)67IMPORTANT:Making a false statement in any registration application or in any proof or statements in connection with it, or deceiving or substituting inconnection 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 theregistration pursuant to regulations established by the Commissioner. The Department makes no representation that it will issue a certificate of title or transferableregistration until the Commissioner is satisfied that the applicant is entitled to a certificate of title or transferable registration, and until all documentation requiredto establish ownership of the vehicle is submitted and deemed to be satisfactory. Pending review of this application, neither the Commissioner of the Departmentof Motor Vehicles nor any of his or her employees, deputies or agents assumes any liability or responsibility for repairs performed, improvements made or workdone to the vehicle referenced in this application.CREDIT CARD AUTHORIZATION IF CARDHOLDER IS NOT THE APPLICANT:My signature authorizes __________________________________________ to use my credit card for payment of any fees in connection with this application.Additional Signature Sign Here Print Name Here (Print Name in Full)Print Additional Name Here  (Sign hERE)Sign Here (Cardholder-Sign Name in Full)Sign Here 5(Assigned by DMV)(Assigned by DMV)