01/08/24

08/17/21

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11704

MV-1 (8/16) PART 2

MV-1 (8/16) PART 2

NONE

NONE

NONE
NYS Department of Motor Vehicles

Restrictions NONE

Changing Address?
If you change your residence, cross out the old address on the front
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
300 SHEFFIELD AVE 2

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

Eyes BR

www.dmv.ny.gov.
INTERIM LICENSE

Restrictions
Probation Date

A ACCEL LEFT OF BRAKE P NO PASSENGERS IN CMV BUS

WEST BABYLON
Endorsements

A1 TEMPORARY VISITOR P1 POWER BRAKES

A2 PROBLEM DRIVER Q POWER STEERING
Birthdate

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

U HAND OPERATED BRAKE
(FOLD ALONG THIS LINE)

LIBERAL

A4 IGNITION INTERLOCK DEVICE

Class D

Sex F

B CORRECTIVE LENSES V MEDICAL VARIANCE

V1 FOOT-OPER PARKING BRAKE
X
RUTH

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
JUN 18 2021

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
18.50

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
I4169543

N2 NO VEHICLE DESIGNED FOR 8 W TOW TRUCK

033428
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

I DONATE $1 TO THE "LIFE - PASS IT ON" TRUST FUND

XX/XX/XX

This Temporary Document is not Valid

18.50

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
JUN 18 2021 WEB
I4169543
LIBERAL

033428
RUTH