Form Mv-82 - Vehicle Registration/title Application

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Class
Office Use Only
VEHICLE REGISTRATION/
Batch
File No.
TITLE APPLICATION
o
o
o
Three of Name
Orig
Activity
Lease Buyout
o
o
o
This form is available at dmv.ny.gov
Dup
Activity W/RR
Sales Tax with Title
I WANT TO:
Plate Number
REGISTER A VEHICLE
RENEW A REGISTRATION
GET A TITLE ONLY
CHANGE A REGISTRATION
REPLACE LOST OR DAMAGED ITEMS
TRANSFER PLATES
1
NAME OF PRIMARY REGISTRANT (Last, First, Middle or Business Name)
NYS driver license ID number of PRIMARY REGISTRANT
DATE OF BIRTH
GENDER
Month
Day
Year
o
o
Male
Female
NAME OF CO-REGISTRANT (Last, First, Middle)
NYS driver license ID number of CO-REGISTRANT
DATE OF BIRTH
GENDER
Month
Day
Year
o
o
Male
Female
TELEPHONE NUMBER
MOBILE TELEPHONE NUMBER
o
o
o
o
Area Code
Area Code
NAME CHANGE?
YES
NO
ADDRESS CHANGE?
YES
NO
(
)
(
)
FORMER NAME (If name was changed you must present proof))
EMAIL
(Include Street Number and Name, Rural Delivery or box number. This address will be on the document.)
THE ADDRESS WHERE PRIMARY REGISTRANT GETS MAIL
Apt. No.
City or Town
State
Zip Code
County of Residence
THE ADDRESS WHERE PRIMARY REGISTRANT RESIDES IF DIFFERENT FROM THE MAILING ADDRESS
(DO NOT GIVE A P.O. BOX.)
.
Apt. No.
City or Town
State
Zip Code
VEHICLE DESCRIPTION
Body Type (mark one)
VEHICLE IDENTIFICATION NUMBER
2
Year
Make
o
o
o
o
2-Door
4-Door
Pick-up
Van
o
o
o
Type of Power (Fuel)
Convertible
Suburban/SUV
Trailer
Color
Unladen Weight
o
o
o
o
o
o
o
o
o
o
Gas
Diesel
Electric
Flex
CNG
Propane
None
Motorcycle
Tow
Other _________
For rentals,buses & taxis
For trailers & commercial vehicles
Office Use Only
For commercial vehicles
Cylinders
Maximum Gross Weight
Seating Capacity
Odometer Reading in Miles
Mileage Brand
Axles
Distance
A
E
N
CHANGES: Describe any vehicle changes and the reasons for the changes. (SUBMIT NYS TITLE IF ISSUED)
If the OWNER of the vehicle is DIFFERENT from the REGISTRANT, the OWNER must complete this section.
3
NYS driver license number of OWNER
NAME OF CURRENT OWNER(s) (Last, First, Middle)
DATE OF BIRTH
Month
Day
Year
Õ
NAME OF CO-OWNER
GENDER
o
o
Male
Female
THE ADDRESS WHERE OWNER GETS MAIL
(Include the Street Number and Name, Rural Delivery or box number)
County
Apt. No.
City or Town
State
Zip Code
ç
(Signature of owner or authorized person, and signature of co-owner if applicable)
(Date)
DEALER USE ONLY - LIEN FILING -
Alterations are not allowed in the lienholder section below
Õ
o
o
Choose one
There are no liens
I am filing for the lienholder(s) listed below
Lien Filing Code
Lienholder Name
Lienholder Mailing Address (number, street, city, state, zip code)
NEW YORK DEALERS ONLY
Reg. Class
Did you issue plates to this vehicle?
Plate Number
Date Temp Issued
Facility ID Number
o
o
Yes
No
ç
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)
OFFICE USE ONLY
New
New
Ins. Co.
Special Conditions
Plate
Class
Code
AT
BV
CF
CO
EO
EX
FL
Sales Tax
Status
Value
Rate
Out of State
Jurisdiction
Audit
IO
NE
NF
NR
NU
OP
OV
($)
Prior
Issuance
Title
Lien
Lien
Lien Release
PA
PI
PK
RC
RE
SC
SO
State
Owner
Number
SP
SR
SS
SV
TE
TL
TO
Proof Submitted
TP
TR
TX
XR
X6
WO
Approved By
Date
Stop/Response/Scoff Law
Reg/Title ______________________________ State_________________
COMPLETE BOTH SIDES
MV-82 (12/16)
PAGE 1 OF 2

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