DPSMV 1799 R03/12 Sworn and subscribed before me this day of Lienholder s Signature RECEIVED/REJECTION DATE S NOTICE If a title license plate or validation sticker is not received within thirty 30 days after submitting application and fees for such contact your nearest Office of Motor Vehicles. LOST STOLEN OR REPLACEMENT D. TITLE CORRECTION PLATE STICKER License Plate Number Error Correct To E. FARM USE STATEMENT I do declare that I am a bona fide farmer and am in the business of farming that...
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You must report any accident occurringin New York State that costs a fatalitypersonal injury or property damage forany person involved totaling more thanone thousand dollars failure to do sowithin 10 days is a misdemeanor yourlicense and/or registration may besuspended if you don't report theaccident on time and according to themv-104 form at the Law Offices ofWilliam Mattar we can walk you throughthe form and answer your questionsthe mv-104 form has two sections a and Bto get started you will need a black inkpen your driver's license and vehicleregistration it is also helpful if youhave a copy of the police reportwhile completing the form if any of thequestions do not apply to your accidentyou should put a dash mark on the lineif you don't know the correct answer youshould put an X on the line the firststep to completing the mv-104 form isreading the instructions provided onpage 2 starting with section a labeledvehicle involvement then at the top ofthe form on page 1 enter in the date ofthe accident including the day and timealong with the number of vehicles andpeople involved in the crashyou'll also need to write down theprecinct number of the police agency ifthe police investigated the accidentthis number should be on the policereport next enter all of your personalinformation in the drivers box on page 1as vehicle 1 writing down your driver'slicense numbername address birth date and otherrequested information the informationyou provide must match the informationon your driver's license exactly theother drivers information should beadded directly across from yourinformation if you didn't exchangeinformation atscene of the accident you can find theother drivers information on the copy ofthe police report under your driverinformation in the registrant box writedown the name address plate numbervehicle make and model and more just asit appears on the registration you willdo the same for the other driversinformation which can again be found onthe police report in the vehicle damagesection of the form indicate theestimated cost of property damage toyour car in the other car involved ifyou're unsure of the amount you maywrite a brief description of the damagesfor each car then circle the diagramthat best describes how your accidentoccurred the accident location box asksyou to write down exactly where themotor vehicle crash occurred thisincludes the county city road and nearbylandmarks such as schools parking lotsor towers to complete the all involvedbox list the names of everyone involvedin the accident then answer questionseight nine ten twelve thirteen andsixteen which address each person'svehicle position safety equipment agesex and injuries refer to page two formore instruction on filling out thissection for the last step in section aenter your insurance informationincluding your policy number VIN numberin policy time period if more than twocars were involved in the...