Form MV-901D "Garageman's Certification and Bill of Sale for Vehicles Worth Less Than $500.00" - New York

What Is Form MV-901D?

This is a legal form that was released by the New York State Department of Motor Vehicles - a government authority operating within New York. Check the official instructions before completing and submitting the form.

Form Details:

  • Released on December 1, 0015;
  • 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 MV-901D 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 MV-901D "Garageman's Certification and Bill of Sale for Vehicles Worth Less Than $500.00" - New York

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GARAGEMAN’S CERTIFICATION AND BILL OF SALE FOR
VEHICLES WORTH LESS THAN $500.00
DISPOSAL OF LAWFULLY TOWED AND/OR STORED VEHICLES UNDER LIEN LAW, SECTION 202
(This form is also available to download from the DMV website: www.dmv.ny.gov)
NOTICE: THE VEHICLE DESCRIBED HEREIN MAY NEVER BE TITLED AGAIN. IT MUST BE DISMANTLED OR SCRAPPED.
AFTER COMPLETION, PLEASE SUBMIT THIS FORM TO THE VEHICLE DISMANTLER OR SCRAP PROCESSOR.
IMPORTANT INFORMATION REGARDING THESE REQUIREMENTS CAN BE FOUND ON FORM MV-901DI.
To knowingly make a false statement or conceal a material fact in this statement is a criminal offense punishable under Section 210.45 of the
Penal Law, and Section 392 of the Vehicle and Traffic Law.
I, the undersigned GARAGEMAN, certify under penalty of perjury as follows (if signing as an authorized representative of a business organization,
such as a corporation, I certify that I possess the personal knowledge to make such certification and I am duly authorized to so certify on behalf of the
business): (1) the undersigned currently holds a valid, perfected Garageman’s Lien on the motor vehicle described herein; (2) such lien represents
accrued and unpaid towing and/or storage charges which remain unpaid to date; (3) the subject vehicle currently has a wholesale value of less than
$500, as indicated by the nationally recognized source checked below; and (4) the undersigned sold this vehicle to the vehicle dismantler or scrap
processor named herein.
1.
Description of Vehicle (a statement of acquisition must be attached [see MV-901DI]):
Year:
Make:
Model:
Plate Number:
State:
Vehicle Identification Number:
(attach photo or tracing)
Wholesale Value of Vehicle: $
2.
Source of Wholesale Value
£
£
£
NADA
Kelly Blue Book
Other
(please describe)
relied upon by the undersigned:
Garageman (a copy of proof of business must be attached [see MV-901DI]):
3.
Business Name:
Facility #
Government Issued ID for person
submitting this form (copy must be
Business Address:
Apt./STE# 
attached):
No.:
City:
State:
Zip Code
4.
Vehicle Dismantler or Scrap Processor
:
Government Issued ID for
Business Name:
Facility #
representative of vehicle dismantler
or scrap processor (copy must be
Business Address:
Apt./STE# 
attached):
City:
State:
Zip Code
No.:
5.
Prior Owner (a copy of verification of prior owner and other lienholders must be attached):
Name:
Street
Address:
Apt./STE#
City:
State:
Zip Code
6.
Lienholders (
Attach additional sheet, if necessary)
Business Name:
Business Name:
Business
Business
Address:
Apt./STE# 
Address:
Apt./STE# 
City:
State:
Zip Code
City:
State:
Zip Code
7.
Service of Notice and Towing and/or Storage Information
(a copy of the Notice of Lien and Sale, and a copy of receipt for mailing must be
[see MV-901DI]):
attached
/
/
/
/
Date of Service of Notice to Owner:
Date of Service of Notice to Lienholder(s):
Date Vehicle was Towed :
Date Storage Began:
Date of Sale:
8.
(Towing authorization must be attached)
9.
10.
/
/
/
/
/
/
I further certify that: the Date of Sale is not (a) prior to thirty days after the date on which Service of Notice was mailed, or (b) prior to sixty days after the
date of the initial tow, whichever is later; no action was brought under Section 201-a of the Lien Law, or, an action was brought and the determination was
in my (our) favor; and the required Notice of Lien was sent to owner(s) and lienholder(s). Proof of certified mailing is attached.
GARAGEMAN’S/REPRESENTATIVE’S NAME - Print
GARAGEMAN’S/REPRESENTATIVE’S TITLE
X
GARAGEMAN’S/REPRESENTATIVE’S SIGNATURE - Please sign name in full
DATE
MV-901D (11/15)
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GARAGEMAN’S CERTIFICATION AND BILL OF SALE FOR
VEHICLES WORTH LESS THAN $500.00
DISPOSAL OF LAWFULLY TOWED AND/OR STORED VEHICLES UNDER LIEN LAW, SECTION 202
(This form is also available to download from the DMV website: www.dmv.ny.gov)
NOTICE: THE VEHICLE DESCRIBED HEREIN MAY NEVER BE TITLED AGAIN. IT MUST BE DISMANTLED OR SCRAPPED.
AFTER COMPLETION, PLEASE SUBMIT THIS FORM TO THE VEHICLE DISMANTLER OR SCRAP PROCESSOR.
IMPORTANT INFORMATION REGARDING THESE REQUIREMENTS CAN BE FOUND ON FORM MV-901DI.
To knowingly make a false statement or conceal a material fact in this statement is a criminal offense punishable under Section 210.45 of the
Penal Law, and Section 392 of the Vehicle and Traffic Law.
I, the undersigned GARAGEMAN, certify under penalty of perjury as follows (if signing as an authorized representative of a business organization,
such as a corporation, I certify that I possess the personal knowledge to make such certification and I am duly authorized to so certify on behalf of the
business): (1) the undersigned currently holds a valid, perfected Garageman’s Lien on the motor vehicle described herein; (2) such lien represents
accrued and unpaid towing and/or storage charges which remain unpaid to date; (3) the subject vehicle currently has a wholesale value of less than
$500, as indicated by the nationally recognized source checked below; and (4) the undersigned sold this vehicle to the vehicle dismantler or scrap
processor named herein.
1.
Description of Vehicle (a statement of acquisition must be attached [see MV-901DI]):
Year:
Make:
Model:
Plate Number:
State:
Vehicle Identification Number:
(attach photo or tracing)
Wholesale Value of Vehicle: $
2.
Source of Wholesale Value
£
£
£
NADA
Kelly Blue Book
Other
(please describe)
relied upon by the undersigned:
Garageman (a copy of proof of business must be attached [see MV-901DI]):
3.
Business Name:
Facility #
Government Issued ID for person
submitting this form (copy must be
Business Address:
Apt./STE# 
attached):
No.:
City:
State:
Zip Code
4.
Vehicle Dismantler or Scrap Processor
:
Government Issued ID for
Business Name:
Facility #
representative of vehicle dismantler
or scrap processor (copy must be
Business Address:
Apt./STE# 
attached):
City:
State:
Zip Code
No.:
5.
Prior Owner (a copy of verification of prior owner and other lienholders must be attached):
Name:
Street
Address:
Apt./STE#
City:
State:
Zip Code
6.
Lienholders (
Attach additional sheet, if necessary)
Business Name:
Business Name:
Business
Business
Address:
Apt./STE# 
Address:
Apt./STE# 
City:
State:
Zip Code
City:
State:
Zip Code
7.
Service of Notice and Towing and/or Storage Information
(a copy of the Notice of Lien and Sale, and a copy of receipt for mailing must be
[see MV-901DI]):
attached
/
/
/
/
Date of Service of Notice to Owner:
Date of Service of Notice to Lienholder(s):
Date Vehicle was Towed :
Date Storage Began:
Date of Sale:
8.
(Towing authorization must be attached)
9.
10.
/
/
/
/
/
/
I further certify that: the Date of Sale is not (a) prior to thirty days after the date on which Service of Notice was mailed, or (b) prior to sixty days after the
date of the initial tow, whichever is later; no action was brought under Section 201-a of the Lien Law, or, an action was brought and the determination was
in my (our) favor; and the required Notice of Lien was sent to owner(s) and lienholder(s). Proof of certified mailing is attached.
GARAGEMAN’S/REPRESENTATIVE’S NAME - Print
GARAGEMAN’S/REPRESENTATIVE’S TITLE
X
GARAGEMAN’S/REPRESENTATIVE’S SIGNATURE - Please sign name in full
DATE
MV-901D (11/15)
reset/clear
reset/clear