Form Mv-82 - Vehicle Registration/title Application Page 2
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ADDITIONAL VEHICLE INFORMATION
QUESTIONS 1-3 MUST BE COMPLETED.
1. Has the vehicle 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 to make the vehicle legal to operate on the road or
highways, is more than 75% of the retail value of the vehicle at the time of loss?
o
o
No
Yes - (If you marked
the vehicle must have an anti-theft examination before it is registered. The title that is issued
Yes
will have the statement “Rebuilt Salvage” on it.)
o
o
2. Is this vehicle registered for your personal use?
Yes
No
If you marked “Yes”, go to the next question (question 3) .
If you marked “No”, check any of these boxes that apply:
o
This vehicle is a passenger vehicle that will be used for hire with a driver and will be operated in the following location(s):
o
o
o
New York City (NYC)
A jurisdiction that is not NYC that regulates taxis
A jurisdiction that does not regulate taxis
o
This vehicle is used as a contracted carrier.
o
This vehicle is a passenger vehicle that is rented without a driver.
o
This vehicle requires a permit for
(Mark the box of the type of permit that was issued and write the permit
commercial operation.
o
o
number on the line.)
NYS DOT Permit No.
Federal DOT Permit No.
___________________
____________________
o
The
this vehicle.
government owns
o
o
o
o
This vehicle is used as (mark one)
an ambulance
an ambulette
a hearse or invalid coach
o
If payment is received to carry passengers, mark this box
.
o
o
This vehicle is used exclusively as a
If payment is received to carry passengers, mark this box.
hearse
o
This vehicle is a
with a gross vehicle weight rating of at least 8,600 pounds.
commercial tow truck
o
This vehicle is used only as a
. (form MV-260F, Part 1, must be attached)
farm vehicle
o
This vehicle is used only as an
agricultural truck or agricultural trailer.
o
This 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”.)
o
o
3. Has this vehicle been modified to change its registration class?
Yes
No
If “Yes”, explain
______________________________
_________________________________________________________________________________________________________________________
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
o
o
purposes and does not have advertising on any part of it. I want (mark one):
Passenger Plates
Commercial Plates
CERTIFICATION:
The information I have given on this application is true to the best of my knowledge. I certify that the vehicle is fully
5
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.
WARNING:
Intentionally making a false statement or providing false or misleading information in connection with this application is a criminal
offense that may subject you to prosecution under the law.
ç
Print Name Here
(Print Name in Full - if registering for a corporation, print your full name and title)
ç
Sign Here
(Sign Here)
ç
Print Additional Name Here
(Print Name in Full)
ç
Additional Signature Sign Here
(Sign Here - Additional signature required for a partnership or if registering this vehicle in more than one name.)
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MV-82 (12/16)
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