Form Mv-522.1 - Application For Access To Dmv Internet Road Test Scheduling System

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APPLICATION FOR ACCESS TO DMV INTERNET
ROAD TEST SCHEDULING SYSTEM
Bureau of Driver Training Programs
Please complete the following:
Driving School Name
Driving School License #
Address
City
State
Zip Code
Phone Number
E-Mail Address (Your e-mail address is required. It can be a maximum of 50 characters)
(
)
Primary User(s):
Additional User(s):
Additional User(s):
Password (Your password should be 6 to 8 characters and may be changed if necessary)
Please note: Only driving school owner(s), corporate officer(s) or employee(s) registered with the department may
be authorized to use this system. To register employees, a completed Personal History (form
) must be
MV-521.1
submitted to the Bureau of Driver Training Programs, Certification & Oversight Unit.
AGREEMENT
I will only schedule or change road test appointments for customers who give me authorization to do so on their
behalf.
I understand that access to the DMV Internet Road Test Scheduling System is a privilege that may be suspended or
revoked by the DMV for any inappropriate use of the system or for any violation of the Commissioner’s
Regulations deemed serious by the Department of Motor Vehicles.
(Print name of Owner/Authorized Official of Driving School)
ç
(Signature of Owner/Authorized Official of Driving School)
(Date)
Send this completed form to:
NYS Department of Motor Vehicles
Bureau of Driver Training Programs
Certification & Oversight Unit
6 Empire State Plaza, Room 221
Albany, New York 12228
MV-522.1 (11/15)
reset/clear

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