Form MV-80W at a glance
What it is: MV-80W is the Application for Tinted Window Exemption; the Vehicle and Traffic Law prohibits most window tint that does not allow at least 70% of any light to pass through.
Who signs: The practitioner signs on the Signature line and enters the Date (Month/Day/Year).
What to bring and attach to Form MV-80W
Page 1 of this application is to be completed by the person requesting the tinted window exemption. Page 2 must be completed by a NYS licensed physician, physician assistant or nurse practitioner. Send to the address at the bottom of page 1: this completed application, a copy of the NYS professional license of the medical provider that completed page 2, and a photocopy of your NYS vehicle registration.
A filled-in Form MV-80W example: a driver requests a tinted window exemption
How to fill out Form MV-80W, box by box
The vehicle registration information
Provide the Last Name, First, M.I., Driver License ID #, Address (Number and Street), Apt. #, City, State, Zip Code and Phone Number as it appears on the vehicle registration, as well as the driver license ID number.
Someone other than the registered owner of the vehicle
If a medical exemption is requested for someone other than the registered owner of the vehicle, provide the following information about that person: Last Name, First, M.I., Driver License ID #, Address (Number and Street), Apt. #, City, State, Zip Code and Phone Number.
If a medical exemption is requested for someone other than the registered owner of the vehicle, provide the Nature of Relationship to Applicant and the Frequency of and Reason for Such Person's Ridership in Applicant's Vehicle.
The certification and signature of the vehicle registrant
By signing, the vehicle registrant certifies and affirms that all information presented in this form is true and correct, that any documents, including supporting documentation, that the registrant has presented to DMV are true, accurate and genuine, under penalty of law. False statements made herein are punishable as a class A misdemeanor pursuant to section 210.45 of the Penal Law. Sign the name in full on the Signature of Vehicle Registrant line, and enter the Date.
The patient
Enter the Patient's Last Name, First Name and M.I., and the Date of Birth (Month/Day/Year).
The examination date
Enter the Examination Date; it must be within 60 days of the date this form is submitted to DMV.
The medical condition
The following medical condition justifies granting an exemption for the patient from the limits on light transmittance found in Vehicle and Traffic Law, and personal protective measures such as sun-protective clothing, sunscreen, eye-protective devices or clear UV-protective window films do not offer adequate protection.
Mark the condition that applies: albinism; chronic actinic dermatitis/actinic reticuloid; dermatomyositis; lupus erythematosus; porphyria; xeroderma (pigmentosa) pigmentosum; severe drug photosensitivity, provided that the course of treatment causing the photosensitivity is expected to be of prolonged duration; photophobia associated with an ophthalmic or neurological disorder; or any other condition or disorder causing severe photosensitivity in which the individual is required for medical reasons to be shielded from the direct rays of the sun.
Enter the medical condition in the line "The medical condition of ... warrants a tinted window exemption."
The light transmission and the protective measures
Enter the minimum level of light transmission required due to the above-certified condition, one of the conditions on the list on page 2.
Enter the reason personal protective measures such as sun-protective clothing, sunscreen, eye-protective devices or clear UV-protective window films do not offer adequate protection.
The physician, physician assistant or nurse practitioner
Enter the Physician/Physician Assistant/Nurse Practitioner's Name (Please print in full), mark Physician, Physician Assistant or Nurse Practitioner, and enter the Mailing Address (Include number and street), City, State, Zip Code and Telephone Number (area code).
Mark Yes or No for "A copy of my NYS professional license is enclosed with this form", and enter the NYS Certificate or Professional License Number.
The practitioner's signature and date
The practitioner signs on the Signature line and enters the Date (Month/Day/Year).
More rules for Form MV-80W
The Medical Practitioner's Statement for Tinted Window Exemption must be completed by a NYS-licensed physician, physician assistant or nurse practitioner, who must print clearly; a copy of the NYS professional license must accompany this form.
Common questions about Form MV-80W
How do I qualify for tint exemption in NY?
The law provides an exemption for any person who, for medical reasons, must be shielded from direct sunlight, but only when personal protective measures such as sun-protective clothing, sunscreen, eye-protective devices, or clear UV-protective window films do not offer adequate protection, and only when such person has a specific medical condition set forth by the Department of Health. The person who requests an exemption may be either the driver or someone who is a regular, habitual passenger in the vehicle (see Vehicle and Traffic Law section 375). NYS Health Department regulations specify that only certain medical conditions can be used to justify an exemption from the limits on light transmittance. A list of these conditions is on page 2.
Where do I file it?
Return this application to: Department of Motor Vehicles, Driver Regulation Bureau, Medical Review Unit, 6 Empire State Plaza, Room 337, Albany NY 12228.
Sources
[1] Form MV-80W (6/24), Application for Tinted Window Exemption, New York State Department of Motor Vehicles (the Official source link on this page).