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PLATE SURRENDER APPLICATION
6 EMPIRE STATE PLAZA, ROOM B240
ALBANY NY 12228
INSTRUCTIONS:
Use this form to surrender your NYS license plate(s). Provide all requested information.
1. Complete a separate application for each set of plates being surrendered.
2. Mail your application and your plates to the address listed above.
3. There is no fee
to surrender plates. Please do not include any payment.
License Plate Number:
Plate Class:
(The 3 letter code above the plate number on the
registration document. Example: PAS; COM; TRL; MOT)
First 3 of Last Name:
(The first three letters of the last name or the
company name on the registration document)
Upon receipt of your plates, DMV will mail you a receipt and, if applicable, the NYS Comptroller’s
Office will mail a registration refund check to the
address on your registration. If your address
has changed and you would like these mailed to your
new address, please provide it below:
1
OR
New Address:
OFFICE USE ONLY
OFFICE USE ONLY
Post Mark Date:
/ /
PD-7 (5/16)
2
