Form Ds-885ce - Article 19-A Add/drop Notice
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1ARTICLE 19-A ADD/DROP NOTICE
Certified Examiner (CE)
dmv.ny.gov
Complete
l
SECTION A (CARRIER INFORMATION).
Complete
for any certified examiner (CE) who is being hired or reinstated with your company.
l
SECTION B (ADDS)
l
Complete
SECTION C (DROPS)
for any certified examiner (CE) who has left service with your company.
Please type or print the following information:
SECTION A - CARRIER INFORMATION
Carrier/DBA Name
Legal Name (if different)
Federal ID Number
19-A Business ID Number
Street Address
City
State
Zip Code
Name of Carrier Representative
Signature of Carrier Representative
Date
ç
SECTION B - ADDS
CE’S NAME
Last
First
M.I.
Effective Date CE Hired/Reinstated
Driver License Number
Date of Birth
State of License
CE #
CE’S NAME
Last
First
M.I.
Effective Date CE Hired/Reinstated
Driver License Number
Date of Birth
State of License
CE #
CE’S NAME
Last
First
M.I.
Effective Date CE Hired/Reinstated
Driver License Number
Date of Birth
State of License
CE #
SECTION C - DROPS
CE’S NAME
Last
First
M.I.
Effective Date CE Dropped
Driver License Number
Date of Birth
State of License
CE #
CE’S NAME
Last
First
M.I.
Effective Date CE Dropped
Driver License Number
Date of Birth
State of License
CE #
CE’S NAME
Last
First
M.I.
Effective Date CE Dropped
Driver License Number
Date of Birth
State of License
CE #
ELECTRONIC CARRIERS:
Add and drop your CEs online using the 19-A system. Keep a copy of the completed DS-885CE in your 19-A files.
Submit the completed form to: New York State Department of Motor Vehicles, Bus Driver Unit, 6 Empire
NON-ELECTRONIC CARRIERS:
State Plaza, Rm 136B, Albany, New York 12228. You can also submit the completed form via Fax at (518) 474-0593 or via e-mail at
busdriverunit@dmv.ny.gov. Keep a copy of the completed DS-885CE in your 19-A files.
The Bus Driver Unit must receive this form within
10 days of the effective date listed above.
RESET/CLEAR
DS-885CE (6/16)
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