Form FS-15 at a glance
What it is: This is the Affirmation under Sections 318(9) & 318(11) of the New York Vehicle and Traffic Law.
Who signs: Sign your name in full.
(4) One year has passed since you complied with the revocation order, and you request that your driving privileges be restored.
A filled-in Form FS-15 example: a driver asks for restored driving privileges
How to fill out Form FS-15, box by box
DMV Case #, Accident Date and Revocation Order #
At the top, enter the DMV Case #, the Accident Date and the Revocation Order #.
Your name and where you reside
Print your name in full in the blank after I; you affirm under penalties of perjury.
(1) Enter where you reside: Number, Street, Apartment No., City, State and Zip Code.
The accident and where you resided
(2) You were involved in an accident as the owner, the operator or both of a motor vehicle: check one or both, and enter the Date of Accident and the Location of Accident.
Enter where you resided at that time: Number, Street, Apartment No., City, State and Zip Code.
Signature, Date of Birth and Date
Sign your name in full, then enter your Date of Birth and the Date.
More rules for Form FS-15
(3) There are no legal actions pending against you which were started within one year from the date of the accident by any damaged party involved, nor are there any unsatisfied judgments outstanding against you resulting from any such legal actions that have been resolved.
Common questions about Form FS-15
Is there a deadline?
This affirmation is not acceptable if completed before what is written in its blank.
Where do I file it?
Complete the form by filling in the blank spaces, and return it to the Insurance Services Bureau, 6 Empire State Plaza, Albany NY 12228.
Sources
[1] Form FS-15 (7/15), Affirmation Under Sections 318(9) & 318(11) of the New York Vehicle and Traffic Law, New York State Department of Motor Vehicles (the Official source link on this page).