Form Mv-463 - Application For Dealer Plate Issuance Program

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DMV OFFICE USE ONLY
APPLICATION FOR DEALER PLATE
REG. CLASS
LIMIT
ISSUANCE PROGRAM
PAS
____________
(Print or Type all information)
MCY
____________
COM
____________
TRL
____________
ATV
____________
SEE PAGE 2 FOR INSTRUCTIONS ON HOW TO FILL OUT THIS APPLICATION
IN-TRANSIT PERMITS ________
This program is restricted to dealers who meet the eligibility requirements set forth in Commissioner’s Regulations Part 78 section
78.23(a), and the Dealer Plate Issuance Manual (MV-461) section 1.2.
1. Facility Identification Number
2. Dealer E-mail Address
3. Contact Person
4. Telephone Numbers (Required)
Fax (
)
Business (
)
Emergency (
)
5. Business Name As It Appears on Your Official Business Certificate
6. Business Address - Street
City
State
Zip Code
County
7. What type of security will you use in storing plates and in-transit permits? (Security for plates and in-transit permits is subject to DMV inspection and approval.)
o
o
o
Locked Safe
Locked Room
Other ______________________________________________________________
8. How many vehicles and trailers did you sell at retail last year?
(a) Passenger
(b) Commercial
(c) Motorcycle
(d) Trailer
(e) ATV
Original ______________
Original ______________
Original ______________
Original ______________
Original ______________
9. Registration plates/in-transit permits are requested
o
o
o
o
o
o
for the following registration classes:
Passenger
Commercial
Motorcycle
Trailer
ATV
In-Transit Permit
Plates and permits issued under this program can be issued only for vehicles and trailers that are sold at retail.
CERTIFICATION:
I certify that I have read, and will abide by, the statutes of the Vehicle and Traffic Law, the Commissioner’s Regulations and
procedures outlined in the Dealer Plate Issuance Manual (MV-461), and, if applicable, the All-Terrain Vehicle Dealer
Registration Instructions (RV-2), governing the Dealer Plate Issuance Program. I understand that any violation of the statute,
Commissioner’s Regulations or procedures may result in the withdrawal of my authorization to participate in the Dealer Plate
Issuance Program, and/or suspension or revocation of my dealer registration or the imposition of a civil penalty.
I further certify that all the information I have provided on this form is true and accurate to the best of my belief.
(Print or Type Name of Officer of Corporation or Owner)
(Print or Type Title)
-
(Signature of Officer of Corporation or Owner)
(Date of Application)
FALSE STATEMENTS MADE ON THIS APPLICATION ARE SUBJECT
TO SECTION 210.45 OF THE PENAL LAW.
RETURN THIS APPLICATION TO:
VIA MAIL
VIA CERTIFIED OR OVERNIGHT DELIVERY
New York State Department of Motor Vehicles
New York State Department of Motor Vehicles
Dealer Plate Issuance Unit
Dealer Plate Issuance Unit
PO Box 2820
6 Empire State Plaza Rm 322
Albany NY 12220-0820
Albany NY 12228
dmv.ny.gov
PAGE 1 OF 2
MV-463 (12/15)

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