Ds 875Y Form PDF Details

Are you looking for a way to reduce your taxable income? If so, you may be interested in the DS 875Y form. This form allows taxpayers to claim certain tax credits that can help them save money on their taxes. In this blog post, we will discuss the DS 875Y form and how it can help taxpayers save money on their taxes. We will also provide some tips on how to complete this form. So, if you are interested in learning more about the DS 875Y form, read on!

QuestionAnswer
Form NameDs 875Y Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesds 875z, nys ds 875 answers, ds form 875z, nysdmv form619

Form Preview Example

DS-875Y (6/11)

NewYorkStateDepartmentofMotorVehicles

ARTICLE 19-AORAL/WRITTEN EXAMINATION RESULTS

INSTRUCTIONS TO CERTIFIED EXAMINER

After administering the exam, and using the answer key provided (Form DS-875Z, “Article 19-A Written Examination AnswerSheet”),completethisformandattachittothedriver’scompletedexamination.

 

 

TYPE OF EXAMINATION

 

 

 

 

 

 

 

 

 

Oral Written

Re-examination

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVER INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Driver’s Last Name

 

 

First

 

 

 

 

M.I.

 

 

Date of Birth (Month/Day/Year)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Street Address

 

 

 

 

 

City

 

State

Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Client/License ID Number

 

 

State

 

Class of Driver’s License

Endorsements

Restrictions

 

 

Expiration Date

(from Driver License)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Driver Signature

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CARRIER INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Carrier/DBA Name

 

Legal Name (if different)

 

 

 

Federal ID Number

19-A Business ID Number

 

 

 

 

 

 

 

 

 

 

 

Street Address

 

 

 

 

City

 

State

 

Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DRIVER EXAMINATION RESULTS

Passed

Failed - Driver Disqualified

EXAMINER’S CERTIFICATION

I certify that I have tested the above driver in compliance with Section 6.12 and/or Section 6.15 of Part 6 of the Commissioner’s Regulations. The employer has been notified of the results.

Certified Examiner’s Name

Client/License ID Number (from Driver License)

Certificate Number

Certification Class

 

 

Endorsements

Restrictions

Expiration Date

Certified Examiner’s Signature

-

Date of Examination

www.dmv.ny.gov

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This PDF form will require specific info to be filled out, thus be certain to take the time to enter what's expected:

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Filling out part 1 in ds 875y

2. The subsequent step is usually to fill in all of the following blanks: DRIVER EXAMINATION RESULTS, Passed, Failed Driver Disqualified, EXAMINERS CERTIFICATION, I certify that I have tested the, Certified Examiners Name, ClientLicense ID Number from, Certificate Number, Certification Class, Endorsements, Restrictions, Expiration Date, Certified Examiners Signature, Date of Examination, and wwwdmvnygov.

Writing section 2 of ds 875y

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