08/18/28

01/21/21

Keep this document until you receive your Photo Document

Ht. 5 8
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MV-1 (8/16) PART 2

MV-1 (8/16) PART 2

NONE

NONE

NONE
NYS Department of Motor Vehicles

Changing Address?
If you change your residence, cross out the old address on the front
Restrictions B

of this document and write in your new address. You must notify
This document expires on

Additional Restrictions

DMV of your new address within 10 days, using DMV Form MV-
NY
Status terminates on

XX/XX/XX

232, which is available to download from the DMV web site at

Eyes BR

www.dmv.ny.gov.
30 WINDSOR PLACE
INTERIM LICENSE

Restrictions
Probation Date

A ACCEL LEFT OF BRAKE P NO PASSENGERS IN CMV BUS

Endorsements

A1 TEMPORARY VISITOR P1 POWER BRAKES

A2 PROBLEM DRIVER Q POWER STEERING
Birthdate

A3 MED CERT EXEMPT R BUILT-UP SEAT/PED/SHOE

LYNBROOK
GROCHMAL

U HAND OPERATED BRAKE

(FOLD ALONG THIS LINE)

A4 IGNITION INTERLOCK DEVICE

Class D

Sex F
DAWN,E

B CORRECTIVE LENSES V MEDICAL VARIANCE

V1 FOOT-OPER PARKING BRAKE
X

C MECHANICAL AID
X NO CARGO IN CMV TANK VEH
Here
Sign

D PROSTHETIC DEVICE
E NO MAN TRANS EQUIPPED CMV X1 FULL HAND CONTROL
E1 AUTOMATIC TRANSMISSION Y SHOULDER HARNESS USE (FOLD ALONG THIS LINE)
Z NO FULL AIRBRAKE EQUIP CMV
NOV 22 2020

F OUTSIDE MIRROR
THIS TEMPORARY DOCUMENT IS NOT VALID

CDA

F1 HEARING AID OR FULL VIEW Z1 WHEEL SPINNER

MIRROR 4 TELESCOPIC LENS 4
FOR IDENTIFICATION PURPOSES

5 NO LIMTD ACCESS RDS

NYS Department of Motor Vehicles

G DAYLIGHT DRIVING ONLY

H LIMITED TO EMPLOYMENT
WEB
****DRIVER LICENSE*****

I LIMITED USE AUTO MAX 40 MPH

I1 LIMTD USE MCY MAX 40 MPH Endorsements
I2 LIMTD USE MCY MAX 30 MPH F FARM CLASS A VEHICLES
I3 LIMTD USE MCY MAX 20 MPH G FARM CLASS B VEHICLES
I4 THREE WHEEL MCY H HAZARDOUS MATERIALS
80.50

K CDL INTRASTATE ONLY M METAL COIL

INTERIM LICENSE

L NO AIRBRAKE EQUIPPED CMV N TANK VEHICLES

*ORGAN DONOR*

M NO CLASS A PASSENGER VEH P PASSENGER TRANSPORT

N NO CLASS A/B PASSENGER VEH R RV GVWR OVER 26,000 LBS.
N1 NO VEHICLE DESIGNED FOR 15 S SCHOOL BUS
OR MORE ADULT PASSENGERS
WEB Fee

T DOUBLES/TRIPLES
I3998904

N2 NO VEHICLE DESIGNED FOR 8 W TOW TRUCK

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OR MORE ADULT PASSENGERS X TANK/HAZMAT
O NO TRACTOR/TRAILER CMV
O1 NO TRACTOR TRAILER CMV/
TRUCK NOT OVER 26,000 GVWR

MV-1 (8/16) PART 4

CDA
F
WEB
NEW YORK STATE DEPARTMENT OF MOTOR VEHICLES

XX/XX/XX

This Temporary Document is not Valid

80.50

for Identification Purposes

****DRIVER LICENSE*****

NYS DOH WILL ENROLL YOU AS AN ORGAN DONOR

D
CUSTOMER RECEIPT
INTERIM LICENSE
Class
Visit us at dmv.ny.gov

DOB
NOV 22 2020 WEB
GROCHMAL

I3998904
DAWN,E

116738