Ds 873 Form PDF Details

Ds 873 form is an important document filed by employers with the Department of Labor. The purpose of the form is to provide detailed information on the wages and hours of employees. The form can be used to ensure compliance with wage and hour requirements, as well as to help employers make sure their employees are being paid fairly. It's important for both employers and employees to understand the Ds 873 form and its implications. For more information, please visit our website. Thank you for reading!

QuestionAnswer
Form NameDs 873 Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesnys 19a ds873 fillable form, DS-873, ds 873, nys dmv form ds 499

Form Preview Example

New York State Department of Motor Vehicles

REPORT ONANNUAL DEFENSIVE DRIVING

PERFORMANCE FOR DRIVER UNDERARTICLE 19-A

DS-873 (6/11)

www.dmv.ny.gov

INSTRUCTIONSTOCERTIFIEDEXAMINER:

Regular observation of a driver’s defensive driving performance must be conducted while the driver is operating the vehicle with passengers.

This observation shall NOT be conducted on the same day as the biennial behind-the-wheel road test.

Discuss performance with driver, complete rating, driver acknowledgement, and examiner certification.

SECTION1 - DRIVER INFORMATION

Driver’s Last Name

 

First

M.I.

Date of Birth (Month/Day/Year)

 

 

 

 

 

 

 

 

 

StreetAddress

 

 

City

 

 

State

Zip Code

 

 

 

 

 

 

 

 

 

Client/License ID Number

State

 

Class of Driver’s License

Endorsements

Restrictions

 

Expiration Date

(from Driver License)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION2 - CARRIER INFORMATION

Carrier/DBAName

Legal Name (if different)

Federal ID Number

19-ABusiness ID Number

 

 

 

 

 

 

 

StreetAddress

 

City

 

State

 

Zip Code

 

 

 

 

 

 

 

SECTION3 - VEHICLE INFORMATION

Type of Vehicle

Adult Seating Capacity

GVWR

 

 

Vehicle Plate Number

State

SECTION4 - OBSERVATION (may be conducted inside or outside the vehicle)

Observation Conducted: oInside oOutside

Satisfactory

Unsatisfactory

Satisfactory Unsatisfactory

1.Observation ........................................

2.Traffic Lane Use

(include center line violation) ............

3.Speed..................................................

4.Properly Signals Intention ..................

5.Turning................................................

6.Vehicle Control....................................

o

o

o

o

o

o

o

o

o

o

o

o

7.Obeys Traffic Signs, Signals

and Road Hazard Signs......................

8.Observes Proper Following Distance..

9.Procedures for Receiving and Discharging Passengers ....................

10. Traffic Interaction ................................

o

o

o

o

o

o

o

o

Comments: (requiredifUnsatisfactorycheckedabove)

SECTION5 - DRIVERACKNOWLEDGEMENT

I acknowledge discussion of my defensive driving performance with the examiner who observed and rated my performance.

 

 

 

 

 

_______________

 

 

 

 

 

 

 

 

(Driver Signature)

 

 

 

 

(Date)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION6 - EXAMINER’S CERTIFICATION

 

 

 

 

 

Certified Examiner’s Name

 

 

 

 

 

Client/License ID Number

 

 

 

 

 

 

(from Driver License)

 

 

 

 

 

 

 

Certificate Number

Certification Class

Endorsements

Restrictions

 

Expiration Date

 

 

 

 

 

 

 

 

I certify that the above report is, to the best of my knowledge, true and correct,

 

Certified Examiner’s Signature

 

that I personally observed the above driver’s defensive driving performance, and

 

 

 

 

that I currently hold a valid examiner certification as required in accordance with

 

 

 

Article 19-Aof the New York State Vehicle and Traffic Law.

 

 

 

 

 

Date of Observation

How to Edit Ds 873 Form Online for Free

nys dmv form ds 499 can be filled in easily. Just make use of FormsPal PDF tool to accomplish the job without delay. The editor is consistently upgraded by us, acquiring awesome functions and growing to be greater. Starting is simple! All that you should do is adhere to the next basic steps directly below:

Step 1: Access the PDF in our editor by clicking the "Get Form Button" in the top area of this page.

Step 2: Using this advanced PDF editing tool, you may accomplish more than just fill out blanks. Edit away and make your documents look sublime with custom textual content put in, or optimize the file's original input to excellence - all accompanied by the capability to incorporate stunning pictures and sign the PDF off.

In an effort to fill out this document, ensure you provide the necessary details in each and every area:

1. The nys dmv form ds 499 involves certain information to be entered. Ensure that the subsequent blank fields are filled out:

Part number 1 of submitting nys 19a ds873 fillable form

2. After this part is filled out, go to type in the applicable information in all these: Speed, Properly Signals Intention, Turning, Vehicle Control, Comments required if, Procedures for Receiving and, Discharging Passengers, Traffic Interaction, SECTION DRIVER ACKNOWLEDGEMENT, I acknowledge discussion of my, Driver Signature, Date, SECTION EXAMINERS CERTIFICATION, Certified Examiners Name, and ClientLicense ID Number from.

Stage # 2 in submitting nys 19a ds873 fillable form

3. This third part should be pretty simple, I certify that the above report is, and Date of Observation - all these form fields will need to be completed here.

nys 19a ds873 fillable form writing process clarified (portion 3)

It's easy to make errors when filling in your I certify that the above report is, and so make sure to take a second look before you decide to send it in.

Step 3: You should make sure your information is right and simply click "Done" to progress further. Sign up with us now and immediately get nys dmv form ds 499, ready for download. Each and every change made is conveniently kept , enabling you to customize the form later if necessary. When using FormsPal, you'll be able to fill out documents without the need to be concerned about personal data incidents or entries getting shared. Our secure software makes sure that your private data is stored safely.