Form AV-2 "Autonomous Vehicle Technology Demonstration/Testing Addendum" - New York

What Is Form AV-2?

This is a legal form that was released by the New York State Department of Motor Vehicles - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on April 1, 2019;
  • The latest edition provided by the New York State Department of Motor Vehicles;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form AV-2 by clicking the link below or browse more documents and templates provided by the New York State Department of Motor Vehicles.

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Download Form AV-2 "Autonomous Vehicle Technology Demonstration/Testing Addendum" - New York

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AUTONOMOUS VEHICLE TECHNOLOGY DEMONSTRATION/TESTING ADDENDUM
PART I: LAW ENFORCEMENT INTERACTION PLAN
The applicant demonstration/test entity shall submit with this application a law enforcement interaction plan to inform law enforcement
officers and first responders how to safely interact with the demonstration/test vehicle(s) in emergency and traffic enforcement situations.
The plan shall include the intended operational design domains in which the entity intends to operate, as defined in the Federal
Automated Vehicles Policy. The law enforcement interaction plan shall also include, but not be limited to, the following:
1. Contact phone number for the representative responsible for demonstration/testing;
2. How the vehicle will be identified/distinguished from other conventional vehicles;
3. How to safely immobilize, disable and tow the vehicle if it is involved in a crash;
4. How to recognize if the vehicle is being operated in an autonomous mode;
5. How to disengage an autonomous mode in the event the operator is incapacitated; and
6. Any other public safety concerns during operation or in the event of a collision, including any that may impact law enforcement,
fire, EMS, or towing professions.
The Law Enforcement Interaction Plan shall be reviewed regularly by the demonstration/test entity and updated as needed to ensure
safety, but at least annually.
PART II: TEST VEHICLE OPERATORS
The applicant test entity named herein certifies that each demonstration/test vehicle operator shall be adequately trained
in the safe operation of the vehicle to ensure both legal and safe operation. Each test vehicle operator shall be listed below:
License
License Number
Expiration Date
Operator Name
Date of Birth
Jurisdiction
Additional operators may be listed on separate page(s) as necessary.
PART III: SIGNATURE/CERTIFICATION
I certify that I am duly authorized to submit this addendum and its component information on behalf of, and with the power to bind,
the entity named herein, and all information I have provided relating to this addendum is true and to the best of my knowledge. The
entity named herein agrees to comply with all conditions set forth during this application process.
WARNING: Intentionally making a false statement or providing false or misleading information in connection with this application is
a criminal offense that may subject you to criminal prosecution under the Law.
Entity Name
(Please Print):
BY, (Sign)
Print Name:
Title:
Date:
/
/
(mm/dd/yyyy)
APPROVAL
Approval Date: ______/______/__________
Superintendent
New York State Police
AV-2 (4/19)
AUTONOMOUS VEHICLE TECHNOLOGY DEMONSTRATION/TESTING ADDENDUM
PART I: LAW ENFORCEMENT INTERACTION PLAN
The applicant demonstration/test entity shall submit with this application a law enforcement interaction plan to inform law enforcement
officers and first responders how to safely interact with the demonstration/test vehicle(s) in emergency and traffic enforcement situations.
The plan shall include the intended operational design domains in which the entity intends to operate, as defined in the Federal
Automated Vehicles Policy. The law enforcement interaction plan shall also include, but not be limited to, the following:
1. Contact phone number for the representative responsible for demonstration/testing;
2. How the vehicle will be identified/distinguished from other conventional vehicles;
3. How to safely immobilize, disable and tow the vehicle if it is involved in a crash;
4. How to recognize if the vehicle is being operated in an autonomous mode;
5. How to disengage an autonomous mode in the event the operator is incapacitated; and
6. Any other public safety concerns during operation or in the event of a collision, including any that may impact law enforcement,
fire, EMS, or towing professions.
The Law Enforcement Interaction Plan shall be reviewed regularly by the demonstration/test entity and updated as needed to ensure
safety, but at least annually.
PART II: TEST VEHICLE OPERATORS
The applicant test entity named herein certifies that each demonstration/test vehicle operator shall be adequately trained
in the safe operation of the vehicle to ensure both legal and safe operation. Each test vehicle operator shall be listed below:
License
License Number
Expiration Date
Operator Name
Date of Birth
Jurisdiction
Additional operators may be listed on separate page(s) as necessary.
PART III: SIGNATURE/CERTIFICATION
I certify that I am duly authorized to submit this addendum and its component information on behalf of, and with the power to bind,
the entity named herein, and all information I have provided relating to this addendum is true and to the best of my knowledge. The
entity named herein agrees to comply with all conditions set forth during this application process.
WARNING: Intentionally making a false statement or providing false or misleading information in connection with this application is
a criminal offense that may subject you to criminal prosecution under the Law.
Entity Name
(Please Print):
BY, (Sign)
Print Name:
Title:
Date:
/
/
(mm/dd/yyyy)
APPROVAL
Approval Date: ______/______/__________
Superintendent
New York State Police
AV-2 (4/19)