Form Dtp-423 - Check List
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1CHECK LIST
Bureau of Driver Training Programs
dmv.ny.gov
EACH
All of the following documents must be submitted with
instructor application.
Name of Driving School:
Name of Instructor Applicant:
State:
Driver License ID Number:
¨
).
Driving School Instructor Application (
Completed
MV-523
¨
Test Results for the applicant named above:
¨
) with Test version indicated at the top.
Written Test answer sheet (
Original
MV-367
¨
Road Sign Examination Chart answer sheet (
).
Original
DTP-2004A
¨
Original
Road Test Evaluation (
MV-501
) for instructors certified to teach in cars. If the instructor
applicant will be teaching in other types of vehicles, you must include the appropriate test forms
for each type of vehicle. Use form
MV-501
for motorcycles. Use form
CDL-200
for trucks, buses,
and/or tractor trailers.
¨
If you are amending a current instructor’s certification, include only the ORIGINAL road test forms
for the new vehicle certification type.
¨
of Driving School Instructor Test Results (
).
Certification
DTP-424
¨
Instructor Applicant’s Qualifications and Identity:
¨
photograph of instructor applicant taken within the last 30 days.
One (1)
¨
of High School Diploma or General Equivalency Diploma (GED)
: If this is a foreign
Copy
Note
diploma, you must contact a New York State-approved evaluator of official documents to obtain
the verification required. A current list of approved evaluators is posted on the Department of
Civil Service’s website:
Please note that we accept ONLY the evaluations performed by these approved evaluators.
Any costs or fees for these evaluations are your responsibility.
¨
Vision Test Report (
) completed following the instructions on the form.
Original
MV-619
¨
of 30-hour Basic Instructor’s Course completion certificate, if completed at this time.
Copy
¨
- If the applicant holds an out-of-state license, please attach a certified abstract of the
Certified Abstract
driver license record.
¨
Fee:
For original applicants only, please remit a check or money order payable to the Commissioner of
Motor Vehicles in the amount of ten dollars ($10).
We cannot accept cash or starter checks.
SEND THIS COMPLETED CHECKLIST ALONG WITH ALL REQUIRED DOCUMENTS TO:
New York State Department of Motor Vehicles
Bureau of Driver Training Programs
Certification & Oversight Unit
6 Empire State Plaza, Room 221
reset/clear
Albany, NY 12228
DTP-423 (12/16)
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