New York > Statewide > Department Of Motor Vehicles
MV-50 Retail MV-50W Wholesale Order Form VS-114I - New York
| MV-50 Retail MV-50W Wholesale Order Form Form. This is a New York form and can be used in Department Of Motor Vehicles Statewide . |
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New York State Department of Motor Vehicles MV-50 RETAIL/MV-50W WHOLESALE ORDER FORM www.dmv.ny.gov INSTRUCTIONS IMPORTANT: You must return a completely used book before we can give you a new book. To order a new supply of MV-50s or MV-50Ws: 1. sign and date this order and enclose a check or money order payable to COMMISSIONER OF MOTOR VEHICLES. DO NOT SEND CASH. 2. write your facility number on your check or money order. 3. optional: If you would like your order returned by express delivery service, add $10.00 to the total cost of your order. 4. allow 2 - 3 weeks for processing and delivery. 5. enclose this form and the books that are being returned in one envelope, and forward the envelope to: Regular Mail Express (FedEx, UPS, Etc.) Bureau of Consumer & Vehicle Safety Services Facility Services 6 Empire State Plaza, Room 220 PO Box 2700 Albany NY 12228 Albany NY 12220-0700 FACILITY INFORMATION Facility Name Address City Facility Number Zip Code Write the serial number of each MV-50 or MV-50W book you are returning with this order form: ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ ______________ Specify the type and number of books you are ordering, and the amount owed: o Retail @ $250.00 per book (Quantity) o Wholesale @ $125.00 per book = = = ______________ books @ $_____________ each For return express delivery of books, add $10.00 $ $ $ TOTAL PAYMENT AMOUNT รง (Authorized Signature) (Date) (Print Name) (Business Phone) (E-Mail Address) A $35.00 FEE WILL BE CHARGED FOR ALL RETURNED CHECKS! VS-114I (6/12) American LegalNet, Inc. www.FormsWorkFlow.com reset/clear
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