Form Mv 44Cr – Fill Out and Use This PDF

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Form Mv 44Cr PDF Details

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Question	Answer
Form Name	Form Mv 44Cr
Form Length	2 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	30 sec
Other names	form mv 44cr, mv 2020, mv 44cr, new york restricted license

Form Preview Example

You must answer the following question: Would you like to be added to the Donate Life Registry?

MV-44CR (11/16)

RESTRICTED USE OR CONDITIONAL

DRIVER LICENSEAPPLICATION

PLEASE PRINT CLEARLY IN BLUE OR BLACK INK.

Case

No.

Order

No.

LAM LRN LDP LNO

IMPORTANT: You cannot use a restricted use license to drive a vehicle for hire, unless your license is suspended or revoked because of an uninsured accident, an insurance lapse, uninsured operation of a motor vehicle, or for delinquent child support payments. You cannot use a restricted use license to operate a commercial vehicle. You cannot use a conditional license to drive a commercial vehicle or a vehicle for hire.

CHECK THE BOX OF THE TYPE OF SERVICE YOU NEED (YOU CAN MARK MORE THAN ONE)

oApply for a restricted oReplace a restricted use or		oRenew a restricted use or	oApply for a	oChange information on a
use license	conditional license	conditional license	conditional license	restricted use or conditional license

IDENTIFICATION INFORMATION

FULL LAST NAME

NYSDRIVERLICENSEORNON-DRIVERIDCARDNUMBER

FULL FIRST NAME

FULL MIDDLE NAME

SOCIALSECURITYNUMBER*(SSN)

*You must provide your SSN. Authority to collect your SSN is granted by Sections 490.3 and 502 of the Vehicle and Traffic Law. The information will be used only for exchange with other jurisdictions, to assist in verification of identity, and to invoke driver license sanctions pursuant to V&T Law Section 510(4-e) and 510(4-f). Your number will not be given to the public, or appear on any form or information request.

SUFFIX

DATE OF BIRTH

SEX

HEIGHT

EYE COLOR

Month

Day

Year

Male

Female

Feet

Inches

Has your name changed? oYes

oNo

If “Yes”, print your former

name exactly as it appears on your present license or non-driver ID card. MOBILE PHONE NUMBER

Area Code ( )

TELEPHONE NUMBER

Area Code

()

ADDRESS WHEREYOU GETYOUR MAIL(This address will appear on your document.)

- Include Street Number and Name, Rural Delivery and/or box number (If PO Box, also fill in “Address WhereYou Live” below)

Apt. No. City or Town

State

Zip Code

County

ADDRESS WHEREYOU LIVE IFDIFFERENT FROM MAILINGADDRESS - DO NOT GIVE P.O. BOX.

Apt. No. City or Town

State

Zip Code

County

Has your mailing address changed? oYes oNo

Has the address where you live changed? oYes oNo

What is the change and the reason for it (new

OTHER CHANGE: license class, wrong date of birth, etc.)?

VETERAN STATUS

oCheck this box if you would like to have “Veteran” printed on the front of your photo document.

You must present proof that indicates an honorable discharge from military service. For more information, refer to form MV-44.1.

NEW YORK STATE ORGANAND TISSUE DONATION (You must fill out the following section)

To enroll in the NYS Department of Health’s Donate LifeSMRegistry, check the “yes” box and then sign and date below. You are certifying that you are: 16 years of age or older; consenting to donate your organs and tissues for transplantation, research or both; authorizing DMV to transfer your name and identifying information to DOH for enrollment in the Registry; and authorizing DOH to allow access to this information to federally regulated organ donation organizations and NYS-licensed tissue and eye banks and hospitals, upon your death. “ORGAN DONOR” will be printed on the front of your DMV photo document. You will receive a confirmation from DOH, which will also provide you an opportunity to limit your donation. If you are 16 or 17 years of age, parents/legal guardians may rescind or amend your decision upon your death.

o Yes(sign and date consent below)

o Skip This Question

♥Donor Consent Signature: ➧________________________________________________________________ Date:_____________

oCheck this box to make a $1 voluntary contribution to the Life...Pass It On Trust Fund. The $1 donation will be added to your total transaction fee. A contribution to the Fund is used for organ donation and transplant research and educational projects promoting organ and tissue donation.

VOTER REGISTRATION QUESTIONS (Please check “yes” or “no”.) NOTE:If you do not check either box, you will be considered to have decided not to register to vote. If you are not registered to vote where you live now, would you like to apply to register, or if you are changing your address, would you like the Board of Elections to be notified?

o YES - Complete Voter RegistrationApplication Section

o NO - I Decline to Register/Already Registered/I do not want to notify

(Not necessary if you will be applying in person at a DMV office).

the Board of Elections of my change of address.

PLEASE COMPLETEAND SIGN PAGE 2.

Eye Test

o Pass

o Corrective Lens

License

NCDL-C

Class

Restrictions

Special

Conditions

Exp. Date

Proof Submitted

Stop/Response

Validation Number

oBirth Certificate

oDriver License/ID

oCredit Card

oPassport

oINS Papers

oImage Retrieval

Approved By

Date

Fee

oSocial Security Card

Other:

Office

NEW YORK STATE VOTER REGISTRATIONAPPLICATION

Only fill this out if you want to register to vote or change your address or other information with the Board of Elections.

If you register to vote, your completed voter registration application will be sent directly to the Board of Elections. If you decline to register, your decision will remain confidential. You will be notified by your County Board of Elections when your voter registration application has been processed.

Are you a citizen of the U.S.? o Yes o No

If you answer NO, you cannot register to vote

Will you be 18 years of age or older on or before election day? o Yes o No

If you answer NO, you cannot register to vote unless you will be 18 by the end of the year.

Telephone Number (optional)

Have you voted before?	Voting information that	Your name was	Your state or NYS
o Yes o No	has changed:		County was:
What Year?	skip if this has not changed or	Your address was
	you have not voted before.	Your address was
	you have not voted before.

Political Party

You must make 1 selection To vote in a primary election, you must be enrolled in one of these listed parties - except the Independence Party, which permits non-enrolled voters to participate in certain primary elections.

MV-44CR (11/16)

I wish to enroll in a political party:	AFFIDAVIT: I swear or affirm that
o Democratic party	AFFIDAVIT: I swear or affirm that
o Republican party		I am a citizen of the United States.
o Conservative party		I will have lived in the county, city, or village for at least 30 days before the election.
o Green party		I meet all requirements to register to vote in New York State.
o Working Families party		This is my signature or mark on the line below.
o Independence party		The above information is true, I understand that if it is not true, I can be convicted and fined up to $5,000 and/or
o Women’s Equality party		jailed for up to four years.
o Reform party
o Reform party
o Other _________________
o Other _________________
I do not wish to enroll in a political party
o No party	Sign X		PAGE 1 OF 2
o No party	Sign X		PAGE 1 OF 2

1.	Have you had, or are you currently receiving treatment or taking medication for any condition which causes unconsciousness or unawareness such as
	convulsive disorder, epilepsy, fainting or dizzy spells, or heart ailment? o Yes o No
	If “Yes”, you and your doctor must complete form MV-80U.1, even if you have been released from the Medical Review Program. This form can be obtained
	at any Motor Vehicles office or at dmv.ny.gov.
2.	Do you need a hearing aid and/or full view mirror while operating a motor vehicle? o Yes o No
3.	Have you lost use of a leg, arm, hand or eye? o Yes o No
	3a.	If you are renewing your license and answered “Yes”, is this a new condition since your last license? o Yes o No
	3b.	If you answered “NO” to 3a, has your condition worsened since your last license? o Yes o No

CERTIFICATION - I certify that the information I have given on this application is true. If I am applying for a replacement license, I certify that the license has been lost, stolen or mutilated and that, if the lost license is found, I will turn it in to the Department of Motor Vehicles. I will pay the full tuition and other required fees for the rehabilitation program (if applicable), attend the program (if required), and will drive within the conditions required for the restricted or conditional license. I understand that failure to do so will result in the revocation of my restricted or conditional license, and the reinstatement of the suspension or revocation against my full license. If I am a male at least 18 but less than 26 years old, I consent to be registered with the Selective Service System, if so required by federal law, and authorize the forwarding of any personal information required for such registration. My signature below also authorizes use of my credit card, if applicable.

IMPORTANT: Making a false statement in any license or non-driver ID card application, or in any proof or statement in connection with it, or deceiving or substituting, or causing another person to deceive or substitute in connection with such application, may subject you to criminal prosecution for a misdemeanor or felony under the Vehicle and Traffic Law and/or the Penal Law.

SIGN HERE ➧

PLEASE PRINT NAME ➧

DATE:

/ /

HOW TOAPPLY FORARESTRICTED USE OR CONDITIONAL DRIVER LICENSE

Follow the instructions below that apply to you. You must apply in person. You can do this at most, but not all, Motor Vehicles offices. Contact the nearest office to find out where you can apply.

TOAPPLY	1.	Complete both sides of this application and sign your name in the “Certification” box.
for a	2.	Present this application and proof of identity. Refer to form ID-44 “Proofs of Identity” for a list of acceptable documents that you can show for proof.
restricted	2.
restricted	3.	Complete the Restricted Use LicenseAttachment (form MV-693) or the Conditional LicenseAttachment (form MV-2020) if applicable, or any
use or	3.
conditional		additional forms provided by the Motor Vehicles office.
license	4.	Pay the appropriate fee.

TO REPLACE	1.	Complete both sides of this application and sign your name in the “Certification’ box. Your name, date of birth and sex must be entered
your restricted		exactly as they were shown on your last license.
use or	2.	Present this application, and proof of identity. Refer to form ID-44 “Proofs of Identity” for a list of acceptable documents that you can show for
conditional	2.
conditional		proof. To replace a mutilated license, turn in the license with this application.
license
license	3.	Pay the appropriate fee.
	3.	Pay the appropriate fee.
	4.	If your Restricted Use LicenseAttachment (form MV-693) orConditional LicenseAttachment (form MV-2020) is lost, you must complete a
		new attachment.

TO CHANGE	1.	Complete both sides of this application (use your new information), and sign your name in the “Certification” box.
information	2.	Present this application, your current license, your Restricted Use LicenseAttachment (form MV-693) or Conditional LicenseAttachment
on your		(form MV-2020), proof of identity, and proof of the change that you need. Refer to form ID-44 “Proofs of Identity” for a list of acceptable
restricted use
restricted use		documents that you can show for proof.
or conditional		documents that you can show for proof.
or conditional
license	3.	Pay the appropriate fee.

TO RENEW	1.	Complete both sides of this application, and sign your name in the “Certification” box.
your restricted	2.	Present this application, the Restricted Use LicenseAttachment (form MV-693) or Conditional LicenseAttachment (form MV-2020),
use or		your current license, and proof of identity. Refer to form ID-44 “Proofs of Identity” for a list of acceptable documents that you can show for proof.
conditional
conditional
license	3.	Take a vision test in any Motor Vehicles office or have your vision tested by one of the following providers: licensed physician, physician
		assistant, registered nurse, nurse practitioner, ophthalmologist, optometrist, optician, pharmacists who are enrolled in DMV’s Vision Registry, staff
		supervised by any of these providers and the staff of organizations that are authorized by the New York State DMV to give the vision test.
	4.	Pay the appropriate fee.

MV-44CR (11/16)

MV-44CR (11/16)	NEW YORK STATE VOTER REGISTRATIONAPPLICATION INFORMATION
	(Please read before you complete application on the other side.)

Use the NYS Voter RegistrationApplication to Register to Vote in NYS Elections, and/or:

OFFICE USE ONLY

changethenameoraddressonyourvoterregistration

becomeamemberofapoliticalparty

changeyourpartymembership

To Register You Must:

beaU.S.citizen;

be18yearsoldbytheendofthisyear;

notbeinprisonoronparoleforafelonyconviction;

notclaimtherighttovoteelsewhere

If you decline to register, your decision will remain confidential. If you believe that someone has interfered with your right to register or decline to register to vote, your right to privacy in deciding whether to register or in applying to register to vote, or your right to choose your own political party or other political preference, youmayfileacomplaintwiththeNYSBoardofElections,40SteubenStreet,Albany,NY12207-2109(phone:1-800-469-6872).

Your completed application will be sent to the Board of Elections and you will be notified by your County Board of Elections when your application has been processed. If you have any questions about filling out the voter registration application or registering to vote, you should call your County Board of Elections or call

1-800-FOR-VOTE (TDD/TTYDial 711) (only for voter registration questions). If you live in NewYork City, you should call 1-866-VOTE-NYC.You may also find answersortoolsattheNYSBoardofElectionswebsite:www.elections.ny.gov

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Pay attention when completing this document. Make certain all necessary areas are filled out correctly.

1. When filling in the conditional license, ensure to complete all essential blank fields in the relevant area. It will help facilitate the process, enabling your information to be handled swiftly and properly.

Filling in section 1 of new york conditional license

2. Just after performing this section, go to the subsequent step and complete all required particulars in all these fields - ADDRESS WHERE YOU LIVE, IF DIFFERENT FROM MAILING ADDRESS, Apt No City or Town, State, Zip Code, County, Has your mailing address changed o, Has the address where you live, OTHER CHANGE, What is the change and the reason, VETERAN STATUS, Check this box if you would like, NEW YORK STATE ORGAN AND TISSUE, You must fill out the following, and To enroll in the NYS Department of.

VETERAN STATUS, You must fill out the following, and Has your mailing address changed o in new york conditional license

Be very careful when completing VETERAN STATUS and You must fill out the following, as this is the part in which many people make mistakes.

3. Within this part, review If you register to vote your, Are you a citizen of the US o Yes, Will you be years of age or older, Telephone Number optional, Have you voted before o Yes o No, Voting information that has, you have not voted before, Your name was, Your address was, Your state or NYS County was, Political Party You must make, MVCR, I wish to enroll in a political, AFFIDAVIT I swear or affirm that, and Sign. Each of these will have to be filled in with highest accuracy.

How one can fill in new york conditional license step 3

4. Completing Have you had or are you currently, Do you need a hearing aid andor, Have you lost use of a leg arm, CERTIFICATION I certify that the, IMPORTANT Making a false statement, SIGN HERE, and DATE is vital in this part - don't forget to take your time and fill out every single empty field!

Completing segment 4 in new york conditional license

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Form Mv 44Cr – Fill Out and Use This PDF

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