N.Y. Comp. Codes R. & Regs. tit. 15 § 28.11

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Current through Register Vol. 46, No. 36, September 4, 2024

Section 28.11 - Address and forms

(a) [Reserved]

(b)Forms.

(1) Schedule A/E (81/2 * 14)

(i) Front

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(ii) Reverse

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(2) Schedule C/E (81/2 * 14)

(i) Front

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(ii) Reverse

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(3) Schedule B (81/2 * 14)

(i) Front

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(ii) Reverse

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(4) Temporary authority (81/2 * 11)

NEW YORK STATE

International Registration Bureau

P.O. Box 2850-ESP

Albany, NY 12220-0850

PH (518) 473-5834

30-DAY TEMPORARY AUTHORIZATION

REGISTRANT:

.........................................................................................................

TA NO:

.........................................................................................................

CARRIER ACCT NO:

.........................................................................................................

VEHICLE DESCRIPTION

YEAR:

.........................................................................................................

MAKE:

.........................................................................................................

VIN:

.........................................................................................................

DATE BEGINS: _ / _ / _ ... DATE EXPIRES: _/_/ _ ...................

This unit is authorized to operate in the Jurisdictions and at the weights listed below:

State/Weight		State/Weight		State/Weight		State/Weight		State/Weight
AR	40000	AZ	40000	IL	40000	NY	40000	WI	40000
MO	40000	WA	40000	MT	40000	TX	40000	VT	40000
**	*******	**	*******	**	*******	**	*******	**	*******
**	*******	**	*******	**	*******	**	*******	**	*******
**	*******	**	*******	**	*******	**	*******	**	*******
**	*******	**	*******	**	*******	**	*******	**	*******
**	*******	**	*******	**	*******	**	*******	**	*******
**	*******	**	*******	**	*******	**	*******	**	*******
**	*******	**	*******	**	*******	**	*******	**	*******

This document is a registration issued to the named registrant for the vehicle and time period indicated above by the New York State Department of Motor Vehicles pending the issuance of permanent registration credentials and/or license plates and is intended for use on that vehicle as if such credentials and plates had been issued and were affixed to the vehicle.

This document may be a photocopy and must be carried in the vehicle at all times. Void if altered or erased.

NYS VALIDATION STAMP

VOID UNLESS VALIDATED

(5) Hunter's permit (81/2 * 11)

_______________________________________________

NEW YORK STATE

DEPARTMENT OF MOTOR VEHICLES

IRP UNIT (518) 473-5834

30-DAY HUNTER PERMIT

Vehicle described herein can be in operation at unladen weight only for time period designated.

Date Issued:

.........................................................................................................

Expiration Date:

.........................................................................................................

Name of Owner:

.........................................................................................................

State Titled:

.........................................................................................................

Address:

City:

.........................................................................................................

State:

.........................................................................................................

Zip Code:

.........................................................................................................

Vehicle Year and Make:

VIN:

.........................................................................................................

Unladen Weight:

.........................................................................................................

Last NY Plate #:

.........................................................................................................

Insurance Company:

Policy Number:

I certify that all information is true and correct and that appropriate insurance coverage is in effect. I understand this permit is for registration purposes only and agree to operate this vehicle in accordance with statutes, rules and regulations of New York State.

... Signature of Owner: .........................................................................................................

VALIDATION

Void if altered or unsigned

_______________________________________________

N.Y. Comp. Codes R. & Regs. Tit. 15 § 28.11