AUTONOMOUS VEHICLE TECHNOLOGY
DEMONSTRATION/TESTING APPLICATION
This application must be submitted and approved prior to any use, test or demonstration of motor vehicles equipped with autonomous
vehicle technology on public highways in New York State. This application may only be completed by manufacturers of “autonomous
vehicle technology,” or entities creating such technology working in conjunction with manufacturers. The term “autonomous vehicle
technology” is defined as the hardware and software that are collectively capable of performing part or all of the dynamic driving
tasks on a sustained basis. “Dynamic driving tasks” include all of the real-time operational and tactical functions required to operate
a vehicle in on-road traffic, excluding the strategic functions such as trip-scheduling and selection of destinations and waypoints.
The applicant agrees to comply with the following conditions for the duration of any approved demonstrations/tests:
l The operation of motor vehicles equipped with autonomous vehicle technology on public highways will be restricted to
demonstration or testing.
l All demonstrations/tests will be conducted under the direct supervision of the New York State Police. (Provide a completed
State Police Addendum, form AV-2).
l A natural person holding a valid license for the operation of the class of motor vehicle equipped with autonomous vehicle
technology will be present in the driver’s seat in such vehicle for the duration of the time it is operated on public highways, and
shall be prepared to and will assume vehicle control when required to operate safely and lawfully.
l All demonstration/test vehicles will comply with all Federal Motor Vehicle Safety Standards (FMVSS).
l All demonstration/test vehicles will comply with all applicable New York State inspection standards.
l All demonstrations/tests will comply with Vehicle and Traffic Law (VTL) Article 22 and VTL Title VII (with the exception of section 1226).
The applicant agrees to submit a report on the demonstration/testing, undertaken by your company pursuant to a DMV permit, to
the Commissioner of Motor Vehicles no later than March 1, 2019. Please send the report to nysdmvautonomous@dmv.ny.gov or mail
to the attention of Autonomous Vehicle Testing & Demonstration, New York State Department of Motor Vehicles, 6 Empire State Plaza,
Room 410B, Albany, NY 12228. Such report shall include:
l The purpose of the demonstrations and tests;
l The date(s) on which the demonstrations and tests were performed;
l A description of the parameters of the demonstrations and tests;
l The location or locations where demonstrations and tests were conducted;
l The total miles traveled with autonomous technology engaged during the demonstrations and tests; and,
l Any findings relating to impact on:
o Safety
o Traffic control
o Traffic enforcement, or
o Emergency services
Full Legal Name of Entity Applying to Demonstrate/Test
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Other Names Entity Uses (DBA/Assumed Name):
PART I: APPLICANT’S IDENTIFICATION
PART II: AGREEMENT TO REPORT PARAMETERS AND RESULTS OF DEMONSTRATION/TESTING
Entity Information
Entity’s Physical Street Address
City State Zip Code
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Telephone Number
Mailing Address (If different than Physical Street Address)
City State Zip Code
Name Title
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Mailing Address
Contact Person Information (all correspondence will be addressed to the individual listed)
Denotes a required field
City
State Zip Code
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Telephone Number
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Email address
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