Form Mv 523 – Fill Out and Use This PDF

Form MV 523 is an official legal form completed and filed by the Department of Motor Vehicles. It bears a standard state filing format, typically used to report any change of address and to request name changes on existing driving documentation. This is a common requirement among registrations issued today and serves as an important basis of affirmation for staying in compliance with the law. With Form MV 523, you can easily make all necessary changes online at the DMV website or instantly on your phone using the mobile application. As a digital document, you can access it at any time, and have the benefit of it being readily available without having to track down hard copies from other sources prior to submitting your application.

Form Mv 523 PDF Details

Form Mv 523 is an important document for businesses in New York. The form is used to report the annual wages paid to employees and the amount of taxes withheld from their paychecks. It's essential that businesses complete and submit this form on time, so they can avoid any penalties from the state government. In this blog post, we'll explain what information is required on Form Mv 523, and we'll provide a few tips for completing it quickly and accurately. Thanks for reading!

Question	Answer
Form Name	Form Mv 523
Form Length	2 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	30 sec
Other names	NYS, nysdmv, 30-hour, degeneracy

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CHECKWHAT YOU NEED

ALL FEES ARE NONREFUNDABLE

OriginalInstructor’sCertificate($10.00)

One-Year Renewal ($10.00)

Two-Year Renewal ($20.00)

Additional Certificate ($0)

Classroom Endorsement ($0)

ChangeofVehicleClassEndorsement($0)

New York State Department of Motor Vehicles

APPLICATION FOR DRIVING SCHOOL

INSTRUCTOR CERTIFICATE

(Please type or print clearly. Applications completed illegibly

or left incomplete will delay processing.)

www.nysdmv.com

FOR OFFICE USE ONLY

Instructor Class ______________ Classroom

Endorsement

Certificate No. ________________________________

Date	/	/	Expiration	/	/
Issued:			Date:

Denial No. _____________			Date	/	/
			Denied:

Last Name

First

M.I.

Social Security Number

Date of Birth (Mo./Day/Yr.)

Sex

Mailing Address (Street & No.)

Place of Birth

Driver LIcense ID No.

City

State

Zip Code

License Class

Expiration Date

Years of Driving Experience

Driver Education Instructor’s Certificate (MV-283) number (attach copy)

Have you had one year of experience as an in-car instructor? No

Yes

If “Yes”, Name of Driving School.

No. of hours: _________

Name and Address of Driving School

sending application:

What type(s) of vehicles will you use for instruction? Auto

Bus

Motorcycle

Tractor-Trailer

Truck

Note: Section 5 of the NYS Tax Law requires the Department of Motor Vehicles to provide Social Security numbers to the NYS Department of Taxation and

Finance upon request.

You must answer ALL the following questions. Questions answered “Yes” must be explained on page 2.

CHECKONE :

YES

Have you ever been convicted of any traffic violations (not parking violations)?

Has your license to drive (or your driving privilege) ever been refused, cancelled, suspended or revoked in New York or any other state?

Have you ever been convicted of any crime or felony involving violence, dishonesty, deceit, indecency, degeneracy or moralturpitude?

Have you ever been convicted of perjury or of making any false statements relating to any part of the New York Vehicle and Traffic Law?...

Are you presently involved with any charges or court proceedings relating to the matters stated in questions1, 3 or 4?

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

Have you ever had a driving school and/or instructor’s certificate denied, cancelled, suspended or revoked?

Have you been an instructor for a Point Insurance Reduction Program within the last 12 months?

Have you given driver training instructions for compensation within the last 12 months?

Do you have any physical impairment that could hinder your ability to perform the duties of a driving instructor?

10.

Have you ever been known by any name other than the one shown on this application?

EDUCATION

Have you:

Yes

School

received a high school diploma or GED (General Educational Development)?

____________

(If “Yes,” attach copy if you are an original applicant.) . . . .

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

. . . . . . .

Date Issued

completed a DMV approved course in traffic safety for driving school

	instructors (30-hour basic)? (If “Yes,” attach copy of certificate.) . . . . . . . . . . . . . . .						____________
	completed a DMV approved advanced course in teaching techniques &						Date Issued

	methodology?	(If “Yes,” attach copy of proof of completion.). . . . . . . . . . . . . . . . . .					____________
							Date Issued

EMPLOYMENT - List employment experience for last 5 years, most recent first. Do not include current employment in a commercial driver training school.
Original applicants must complete this section:
	Name of Firm					Address of Firm

	Kind of Work			Dates Employed				Reason for Leaving
				;		To
				From		To
	Name of Firm					Address of Firm

	Kind of Work			Dates Employed				Reason for Leaving
				;		To
				From		To
	Name of Firm					Address of Firm

	Kind of Work			Dates Employed				Reason for Leaving
				From		To

					FOR OFFICE USE ONLY
	Approved	Disapproved	By: _____________________________________________________________ Date__________________

PAGE 1 OF 2

		New York State Department of Motor Vehicles
		CASHIER’S RECEIPT FOR THE BUREAU OF DRIVER TRAINING PROGRAMS
Received from		____________________________________________________________________________________________
Address	__________________________________________________________________________________________________
Amount	__________________________________________________________________________________________________

MV-523 (2/09)		The validation number on this receipt is the same as the number stamped on the application.

Instructor Certificate No.

Social Security Number _________________________________________

EXPLANATIONS

Identify by name and address all driving schools at which you have worked in the past 5 years; list most recent first.

If you answered “Yes” to any questions on the front of this form, give the details below. Identify the number of the question being answered.

The applicant agrees that:

1.if I end my employment with the driving school, I will immediately surrender my instructor’s certificate to the school. (Theschoolisrequiredtoforward thecertificate totheDMV).

2.if I become employed by another driving school, I will apply for a new instructor’s certificate for that school.

3.if my driver license is suspended or revoked, my instructor certificate is not valid, and I must surrender the certificate toDMV.

4.if DMV determines that I am not entitled to the certificate, I will immediately surrender my certificate to the driving school. (Theschoolis requiredtoforwardthecertificate totheDMV).

5.if I lose my certificate, I will report the loss immediately, in writing, to the DMV.

6.I will carry the instructor’s certificate at all times while giving driving instructions or when I am accompanying a studentto a DMV road test.

7.the instructor’s certificate will be valid only to give driving and/or classroom instruction in the course of my employment or association with the driving school identified on this application.

I affirm that I have read this entire application; that I know its contents and that all answers, statements and all other matters contained in it are true. I understand that any false statement will result in the revocation of any driving school instructor’s certificate that has been issued to me. NOTE: It is a criminal offense to knowingly make a false statement or conceal a material fact in this application. To do so will result in the revocation of your instructor certificate.False statements are punishable under Section 210.45 of the Penal Code.

Applicant’s Signature➧______________________________________________________ Date _____________________________

This application must be signed by an authorized official of the driving school.

Signature of Driving

School Official➧_____________________________________________________ Title________________________________ Date __________________

WHATISNEEDED:Findthesectionbelowthatappliestotheactionyouwanttotake.Itliststhedocumentsyoumustprovidetocompleteyourapplication.

✔ AN ORIGINAL INSTRUCTOR CERTIFICATE
✔ AN ORIGINAL INSTRUCTOR CERTIFICATE
A $10 check or money order payable to the Commissioner of Motor Vehicles
Two photographs no more than 30 days old		ATTACH
Two photographs no more than 30 days old		PHOTO(S)
A copy of the applicant’s high school diploma or General Educational Development (GED)		PHOTO(S)


A copy of the applicant’s written and road sign test
A copy of the applicant’s road test results for the type of vehicle used in instruction		Photograph(s) must have been
		taken within past 30 days and
A copy of the Visual Acuity Report (form MV-619) completed by applicant’s health care professional		taken within past 30 days and
		should be 1 7/8’’ wide x 2’’ long,
✔ A RENEWAL INSTRUCTOR CERTIFICATE		should be 1 7/8’’ wide x 2’’ long,
✔ A RENEWAL INSTRUCTOR CERTIFICATE		and must be a true likeness
For a one-year renewal, send a $10 check or money order payable to the Commissioner of Motor Vehicles		showing only the shoulders, neck
For a two-year renewal, send a $20 check or money order payable to the Commissioner of Motor Vehicles		anduncoveredhead.

Two photographs no more than 30 days old

Proof of completion of the 30-Hour Basic Course for the preparation of professional driving school instruction(THE 30-HOUR BASIC COURSE

MUST BE COMPLETED WITHIN A YEAR FROM THE DATE THE ORIGINAL INSTRUCTOR CERTIFICATE ISISSUED)

✔CLASSROOM ENDORSED INSTRUCTOR CERTIFICATE

Send a copy of the required 30-Hour Basic Course completion certificate

Send proof of completing an approved advanced program in Teaching Techniques and Methodology(ONE YEAR OF BEHIND-THE-WHEEL

INSTRUCTION WILL ALSO BE NECESSARY FOR CLASSROOM ENDORSEMENT)

Mail completed applications to: NYS Department of Motor Vehicles, Bureau of Driver Training Programs, 6 ESP, Room 412, Albany NY 12228.

MV-523 (2/09)

PLEASE ALLOW 6-8 WEEKS FOR PROCESSING

PAGE 2 OF 2

How to Edit Form Mv 523 Online for Free

You may complete MV-619 effortlessly by using our PDFinity® online tool. Our tool is constantly evolving to give the very best user experience achievable, and that's because of our commitment to continuous enhancement and listening closely to feedback from users. In case you are seeking to get going, here is what it's going to take:

Step 1: Simply press the "Get Form Button" in the top section of this webpage to launch our pdf form editing tool. This way, you'll find all that is needed to work with your document.

Step 2: Using our online PDF editing tool, you'll be able to do more than simply fill in blanks. Express yourself and make your documents appear great with custom text added in, or fine-tune the original content to perfection - all comes with an ability to incorporate your personal photos and sign the document off.

Concentrate when filling out this document. Ensure that every field is done properly.

1. Whenever filling in the MV-619, make certain to complete all of the necessary blank fields in their corresponding area. It will help to speed up the work, allowing for your information to be handled fast and appropriately.

2. Just after filling in the previous section, go to the subsequent step and fill out the necessary details in these blank fields - You must answer ALL the following, EDUCATION Have you, Yes No, School, received a high school diploma or, If Yes attach copy if you are an, completed a DMV approved course, instructors hour basic If Yes, completed a DMV approved advanced, methodology If Yes attach copy of, Date Issued, Date Issued, Date Issued, EMPLOYMENT List employment, and Address of Firm.

Be very mindful while filling in EMPLOYMENT List employment and methodology If Yes attach copy of, because this is where a lot of people make a few mistakes.

3. This next stage is going to be straightforward - fill in all of the blanks in Kind of Work, Name of Firm, Kind of Work, Dates Employed From To, Address of Firm, Dates Employed, From To, FOR OFFICE USE ONLY, Reason for Leaving, Reason for Leaving, Approved Disapproved, By Date, PAGE OF, CASHIERS RECEIPT FOR THE BUREAU OF, and New York State Department of Motor to finish this segment.

4. This next section requires some additional information. Ensure you complete all the necessary fields - Social Security Number, EXPLANATIONS Identify by name and, If you answered Yes to any, The applicant agrees that, if I end my employment with the, the certificate to the DMV, if I become employed by another, if my driver license is suspended, if DMV determines that I am not, and required to forward the - to proceed further in your process!

the certificate to the DMV, if my driver license is suspended, and EXPLANATIONS Identify by name and in New_York

5. Since you get close to the conclusion of this document, you'll notice a few more things to do. Particularly, I affirm that I have read this, Signature of Driving School, This application must be signed by, WHAT IS NEEDED Find the section, AN ORIGINAL INSTRUCTOR CERTIFICATE, A check or money order payable, A RENEWAL INSTRUCTOR CERTIFICATE, ATTACH PHOTOS, Photographs must have been taken, For a oneyear renewal send a, MUST BE COMPLETED WITHIN A YEAR, CLASSROOM ENDORSED INSTRUCTOR, Send a copy of the required Hour, INSTRUCTION WILL ALSO BE NECESSARY, and Mail completed applications to NYS must be filled out.

Step 3: You should make sure the details are accurate and just click "Done" to continue further. Try a 7-day free trial plan at FormsPal and acquire instant access to MV-619 - which you'll be able to then use as you want in your FormsPal account page. FormsPal is committed to the privacy of our users; we make sure all personal data handled by our tool is protected.

Form Mv 523 – Fill Out and Use This PDF

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