Form MV-15D - Motor Vehicle Record Search Account Application - New York

Organization: ______________________________________________________________________________________

Address: __________________________________________________________________________________________

City: __________________________________________________ State:_________ Zip Code:____________________

Telephone: _______ - _______ - __________ Ext. ____________ Fax: _______ - _______- __________

Email Address: ____________________________________________________________________________________

Federal Employer ID Number:

Please describe in detail how you plan to use the information from searches of DMV’s records:

If DMV has ever terminated a search account held by you, your organization, or any principal, agent, officer or

deposit amount should fund your estimated usage for two months. Electronic searches are $7 each. Mail order searches

are $10 or more, depending on what kinds of certified documents you request. Please make your check or money order

payable to “Commissioner of Motor Vehicles”.

u If you represent a commercial or not-for-profit organization (including volunteer fire companies and volunteer

ambulance services),

include a certified copy of your business certificate.

u Send the form to: DATA SERVICES - NEW SEARCH ACCOUNT

NYS DEPARTMENT OF MOTOR VEHICLES

6 EMPIRE STATE PLAZA

ALBANY NY 12228

Applicant: ________________________________________________________________________________________

Applicant’s Driver License Number: _________ - _________ - _________ State/Province: ______________________

u legal aid bureau or society or other private

entity when acting pursuant to Section 722 of

the New York State County Law;

(DO NOT GIVE P.O. BOX)