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Vs 35 Nys Dmv Details

Vs 35 form is a document that is used to report the outcome of an election. The form is created by the each state's board of elections and helps to ensure the accuracy of election results. The form can be used to report the results of a primary, general, or special election.

You can find more details in regards to the vs 35 form by checking out the table we compiled.

Question	Answer
Form Name	Vs 35 Form
Form Length	2 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	30 sec
Other names	dmv vs 35, dmv vs35 form, amazon, vs35 file online

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VS-35 (3/11)

New York State Department of Motor Vehicles

FOR OFFICE USE ONLY

Division of Vehicle Safety

Facility

COMPLAINT REPORT

Number

INSTRUCTIONS: (Before filing your complaint, please attempt to settle this matter with the facility.)

C.O. Case

Check the appropriate box to show the type of complaint involved.

Number

CSR

Vehicle repair

Vehicle inspection

Vehicle purchase

We can only accept complaints about repairs up to 90 days or 3,000 miles (whichever

Region

County

comes first) after the date repairs were completed. The only exception is a written warranty that

may exceed these time and/or mileage limits.

R.O. Case

PLEASE PRINT OR TYPEALLENTRIESAND USE BLACK INK

Number

Your

Name of

Name

Facility

Address - Number

and Street

City

State

Zip Code

City

State

Zip Code

Telephone Number (Include area code)

Telephone Number

Home (

)

Work (

)

(Include area code) (

)

Vehicle Identification

Identification Number

Number

of Facility

Vehicle Year, Make, Model

Plate

Cylinders

Name of Person with whom

Number

you dealt at facility

Date of repair/inspection/purchase

Odometer reading at time of repair/

Today’s

Current odometer reading at time

inspection/purchase

Date

of filing the complaint

ANSWER QUESTIONS BELOWAND/OR ON PAGE 2 OF THIS FORM THATAPPLYTO YOUR COMPLAINT

A.RepairComplaint

1.Describe the specific reason you brought the vehicle to the repair shop:____________________________________________________

____________________________________________________________________________________________________________

2.	Did you ask for a written estimate of the parts and labor necessary to do the repair? Yes								No	If Yes, attach a copy of the estimate.
3.	What was the actual cost of repair? $____________________ (Attach invoice)
4.	Beforetherepairwasperformed,didyouaskthatanyreplacedpartbereturnedtoyou?Yes								No
	IfYes,doyouhavethereplacedparts?	Yes	No
5.	Did you authorize any additional repairs? Yes		No	Specify ______________________________________________________
6.	Were you charged for work not performed? Yes No Explain					____________________________________________________
	____________________________________________________________________________________________________________
	____________________________________________________________________________________________________________
7.	Was any unnecessary or unauthorized work performed? Yes				No Specify		__________________________________________
	____________________________________________________________________________________________________________
	____________________________________________________________________________________________________________
8.	Did you go to another facility to have the problem corrected? Yes*					No
	* If Yes, attach invoice and give us the following information about the facility:
	Name _____________________________________________________________ Facility ID No. ______________________________
	Street________________________________________________________________________________________________________
	City __________________________ State __________ Zip Code _____________ Telephone No. (									)	______________________
B.InspectionComplaint
1.	Did the inspection station refuse to inspect your vehicle? Yes				No
2.	Did the inspection station refuse to give you an appointment date in writing? Yes							No
3.	Were you told or led to believe that repairs necessary to pass inspection had to be made at the same station?										Yes No
4.	How much were you charged for the inspection $___________________.
5.	Inspection Certificate # _________________________			Expiration Date			/	/
6.	Did you receive an inspection receipt?	Yes	No	If yes, attach a copy of the receipt.
											PAGE 1 OF 2

C.VehiclePurchaseComplaint
Attach a copy of your Bill of Sale and/or Certificate of Sale.
1.	Were any vehicle components in need of repair or adjustment?	Yes	No	If Yes, which components? ____________________
	____________________________________________________________________________________________________________
2.	Have you gone back to the dealer for repairs or adjustments?	Yes	No	If No, would you go back if the dealer offered to make
	repairs or adjustments? Yes No
3.	Was a Temporary Certificate of Registration issued? Yes	No	If yes, what is the facility number written on the temporary
	registration? ___________________________

4. Inspection Certificate # _________________________ Expiration Date _________________________

/ /

NOTE: If a repair or diagnosis of the vehicle was made, complete Section Aon the front of this form.

D.If there is additional information that will help us to evaluate your complaint, please include this information below or use an additional sheet of paper..

E.What do you want done to resolve this complaint to your satisfaction?

Are you willing to appear and testify at a hearing if one is held to resolve this complaint? Yes No

Be sure to attach COPIES of any supporting correspondence and/or documents such as receipts, invoices, written estimates, written guarantees or warranties, cancelled checks or credit card transaction forms.

Sign below and mail this complaint form with all necessary attachments to: BUREAU OF CONSUMER & FACILITYSERVICES, PO BOX 2700-

ESP,ALBANYNY12220-0700. Phone #: (518) 474-8943 Fax:(518) 486-4102

I understand that a copy of this form and any or all of the enclosed information may be sent to the facility shown on the front of this form. All information provided in this complaint is true and factual.

➧
________________________________________________	_______________________
(Signature)	(Date)

VS-35 (3/11)

www.dmv.ny.gov

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