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REQUEST FOR COPY OF ACCIDENT REPORT
Get accident reports instantly by purchasing them on the web.
Visit http://dmv.ny.gov/AIS before you use this form.
Use only for accidents that happen in New York State.
I am the authorized representative of a person who is, or
I am named in this accident report, or I am the
Please
who may be, a party to a civil action arising out of the
authorized representative of a person named in
choose one
conduct described in this accident report.
this report.
I am a representative of New York State or of a political
of the
I am, or may be, a party to a civil action arising
subdivision of New York State, and will use this accident report
following:
out of the conduct described in this accident report.
ONLY for statistics or research relating to highway safety.
Other reason:
Please Print Requester's Name and Address:
Requester’s
Signature
X
Date of
Signature
To knowingly make a false statement or conceal a material fact in this written statement is a criminal offense, punishable under
Penal Law Section 210.45.
Provide as much information as you can about the accident:
Accident Date:
/ /
If more than 3 motorists were involved, please
attach an additional MV-198C.
Accident
Location (County):
Fatal Accident: YES
Responding Police Agency:
NYC Precinct # Accident #
NYS Police
Local
Plate No.
Driver License ID No. or No. from Non-Driver ID Card
NAME
Date of Birth
Address Apt. No.
City State Zip Code
Plate No.
Driver License ID No. or No. from Non-Driver ID Card Plate No. Driver License ID No. or No. from Non-Driver ID Card
NAME
Date of Birth
NAME
Date of Birth
Address Apt. No. Address Apt. No.
City State Zip Code
City State Zip Code
Check boxes below for all reports you are requesting:
Police Report
Motorist Report (NAME)
Motorist Report (NAME)
Motorist Report (NAME)
MV-198C (1/18)
Mail completed form and payment to: NYSDMV, MV-198C Processing, 6 Empire State Plaza, Albany NY 12228.
Non-refundable search fee . . . . . . . . . . . . . . . . . . .
$10.00
No. of reports requested x $15 . . . . . . . . .
$
Optional - Your reference number:
$
Total Amount Enclosed . . . . . . . . . . . . . . . . . . . . . . .
Please select payment method (Do Not Send Cash):
DMV USE ONLY
DMV account number
Date:
Check/Money Order - Payable to Commissioner of Motor Vehicles
Exempt
Transaction #:
Print name and address where the accident report(s) should be mailed:
Operator:
Records Found No Records Found
Search fee (non-refundable) . . . . . . .
$10.00
No. of Reports x $15 . . . . .
$
Total . . . . . . . . . . . . . . . . . . . . . . . . .
$
Amount Received . . . . . . . . . . . . . . .
$
MV-198C (1/18)
dmv.ny.gov
Refund. . . . . . . . . . . . . . . . . . . . . . . .
$
