Form Mv-198c - Request For Copy Of Accident Report
Download a blank fillable Form Mv-198c - Request For Copy Of Accident Report in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Mv-198c - Request For Copy Of Accident Report with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1REQUEST FOR COPY OF ACCIDENT REPORT
Use only for accidents that happen in New York State.
Get accident reports instantly by purchasing them on the web.
Visit before you use this form.
o
o
I am named in this accident report, or I am the
I am the authorized representative of a person who is, or
Please
who may be, a party to a civil action arising out of the
authorized representative of a person named in
choose one
conduct described in this accident report.
this report.
o
of the
o
I am a representative of New York State or of a political
I am, or may be, a party to a civil action arising
subdivision of New York State, and will use this accident report
following:
out of the conduct described in this accident report.
ONLY for statistics or research relating to highway safety.
o
Other reason:____________________________________
Please Print Requester's Name and Address:
_______________________________________________
Requester’s
X
Signature
Date of
Signature
To knowingly make a false statement or conceal a material fact in this written statement is a criminal offense, punishable under
Penal Law Section 210.45.
Provide as much information as you can about the accident:
/
/
Accident Date: ____________________________________
If more than 3 motorists were involved, please
attach an additional MV-198C.
Accident
Location (County): ____________________________________
Driver License ID No. or No. from Non-Driver ID Card
Plate No.
o
Fatal Accident:
YES
NAME
Date of Birth
Responding Police Agency:
o
NYC Precinct # ______________ Accident #___________________
Address
Apt. No.
o
NYS Police______________________________________________
o
City
State
Zip Code
Local __________________________________________________
Plate No.
Driver License ID No. or No. from Non-Driver ID Card
Plate No.
Driver License ID No. or No. from Non-Driver ID Card
NAME
Date of Birth
NAME
Date of Birth
Address
Apt. No.
Address
Apt. No.
City
State
Zip Code
City
State
Zip Code
Check boxes below for all reports you are requesting:
o
o
Police Report __________________________________________
Motorist Report (NAME) ______________________________
o
o
Motorist Report (NAME)_________________________________
Motorist Report (NAME) ______________________________
MV-198C (1/18)
Mail completed form and payment to: NYSDMV, MV-198C Processing, 6 Empire State Plaza, Albany NY 12228.
Non-refundable search fee . . . . . . . . . . . . . . . . . . . $10.00
No. of reports requested ______ x $15 . . . . . . . . . . ____________
$
Optional - Your reference number:
Total Amount Enclosed . . . . . . . . . . . . . . . . . . . . . . . ____________
$
_________________________________________
Please select payment method (Do Not Send Cash):
o
DMV USE ONLY
DMV account number
o
Date:______________________________________
Check/Money Order - Payable to Commissioner of Motor Vehicles
o
Exempt
Transaction #: ______________________________
Print name and address where the accident report(s) should be mailed:
Operator: __________________________________
o
o
Records Found
No Records Found
Search fee (non-refundable) . . . . . . . $10.00
No. of Reports _______ x $15 . . . . . ____________
$
Total . . . . . . . . . . . . . . . . . . . . . . . . . ____________
$
Amount Received . . . . . . . . . . . . . . . ____________
$
$
Refund. . . . . . . . . . . . . . . . . . . . . . . . ____________
dmv.ny.gov
MV-198C (1/18)
reset/clear
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal