NYS DMV Form MV-1441.3. Certification of Lost License, Permit or Plates

This form is used when an individual is required to surrender their New York State (NYS) driver license, learner permit, or vehicle plates due to a suspension or revocation, but the document or plates have been lost. The purpose of this form is to certify the loss and provide necessary information for documentation purposes.

The form consists of fields where the individual can provide their personal information, such as name, address, date of birth, and NYS driver license/learner permit number. There is also a section to explain the circumstances of the loss and any relevant details.

When filling out this form, it is important to accurately and clearly describe the circumstances surrounding the loss of the license, permit, or plates. Providing any supporting documents, such as a police report or affidavit, may be helpful in the submission process.

Application Example: If an individual's NYS driver license has been suspended and they have lost the physical license, they would complete Form MV-1441.3 to certify the loss. By submitting this form to the appropriate authorities, they can meet the requirement of surrendering the license even if it cannot be physically returned.

Related Forms: There are no directly related forms specified for this particular form. However, individuals may need to follow additional procedures depending on the reason for the suspension or revocation.