Town of Oyster Bay
Office of the Town Clerk
54 Audrey Avenue
Oyster Bay, NY 11771
516-624-6332
Fax 516-624-6396
Richard LaMarca, Town Clerk
www.oysterbaytown.com
Email: townclerk@oysterbay-ny.gov
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Personal Information: Vehicle Information:
Application Date Vehicle Make and Model
Applicants Name Vehicle License Plate Number
Applicants Street Address NYS DMV Clean Pass Vehicle
Verified from Vehicle Registration
City State Zip Code
Approved by:
Applicants Telephone Number
Applicants Signature Office of the Town Clerk
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