Form Mv-104l - Instructions For Completing Report Of Motor Vehicle Accident Page 8
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12APPENDIX A
MV-14P (1/13)
New York State Department of Motor Vehicles
ENFORCEMENT AGENCY FORMS REQUISITION
Date: _____________________________________
Please print all information.
Agency Name
County
NCIC/ORI No.
Street Address
City or Town
State
Zip Code
TSLE&D Data Entry Site
Phone #
Circle the appropriate form number and enter the number of forms you need under “QUANTITY.”
NAME OF FORM
QUANTITY
FORM NUMBER
REPORT OF REFUSAL TO SUBMIT TO CHEMICAL TEST
AA-134
AA-134A
REPORT OF REFUSAL TO SUBMIT TO CHEMICAL TEST (Under Age 21, Section 1194-a)
REPORT OF REFUSAL TO SUBMIT TO CHEMICAL TEST-VESSEL/SNOWMOBILE
AA-134V
*
NOTICE OF CHEMICAL TEST REFUSAL HEARING (Under Age 21, Section 1194-a)
AA-137A
*
NOTICE OF HEARING/OPER. MV AFTER CONSUMING ALCOHOL (Under Age 21, Section 1194-a)
AA-137A.1
POLICE AGENCY REQUEST FOR DRIVER REVIEW
DS-5
ENFORCEMENT AGENCY FORMS REQUISITION
MV-14P
MV-54.1
POLICE GUIDE TO VEHICLE & TRAFFIC LAW
REPORT OF LOST, STOLEN OR CONFISCATED MOTOR VEHICLE ITEMS
(PADS)
MV-78B
REPORT OF MOTOR VEHICLE ACCIDENT (MOTORIST FORM)
MV-104
MV-104A
POLICE ACCIDENT REPORT
(PADS)
MV-104AN
POLICE ACCIDENT REPORT (NYC)
(PADS)
MV-104C
BICYCLE ACCIDENT REPORT
POLICE REPORT FOR FATAL MOTOR VEHICLE ACCIDENTS
MV-104D
MV-104EN
EARLY NOTIFICATION OF A FATAL ACCIDENT
REPORT OF MOTOR VEHICLE ACCIDENT/POLICE LINE OF DUTY ACCIDENT
MV-104L
MV-104S
TRUCK AND BUS SUPPLEMENTAL POLICE ACCIDENT REPORT
ACCIDENT RECORDS BUREAU REPLY ENVELOPE FOR FATAL ACCIDENT REPORTS
MV-299F
PRE-ADDRESSED ENVELOPES FOR TSLE&D DATA ENTRY SITE
MV-316
P-33
POLICE ACCIDENT REPORT MANUAL/INCLUDING TRUCK & BUS SUPPLEMENT
Web only, no print
UT-50
TRAFFIC TICKET (TSLED)
TRAFFIC TICKET (TVB)
UT-60
UT-4
ENFORCEMENT AGENCY TICKET TRANSMITTAL
REPORT OF LOST OR VOIDED TICKETS
UT-8
DUPLICATE ARREST RECORD
UT-19
*
Waivers are on the back of forms AA-137A and AA-137A.1.
This requisition should be mailed to:
NYS Department of Motor Vehicles
You may FAX this form to:
TSLE&D Program
(518) 473-6597 OR
OR
6 Empire State Plaza, Room 424E
Send an e-mail to:
Albany NY 12228
tsledsupply@dmv.ny.gov
-96-
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