MV-1441.3

The NY DMV MV-1441.3 form, titled Certification of Lost License, Permit or Plates, is a legal document used by individuals to explain why they are unable to return a driver license, learner permit, non-driver ID, or license plates to the Department of Motor Vehicles. This certification is typically required when a person is serving a suspension or revocation period, as the DMV often requires the physical surrender of these items before the compliance period can begin or before driving privileges can be restored. By filing this form, the applicant authorizes the DMV to officially surrender and invalidate the specified items in their records.

The form requires the user to provide personal details including their License ID number, full name, and mailing address. Users must check specific boxes indicating which items are missing—such as a photo driver license, temporary permit, or specific license plates—and provide a written explanation for the loss. If license plates are reported as stolen or if both plates are lost, the DMV generally requires a police report (form MV-78B); however, if a police agency denies a request for such a report, the MV-1441.3 serves as a self-certification of the loss, provided the applicant includes the date of the request and the name of the police agency that denied it. Signing the form under penalty of perjury serves as a formal declaration that the explanation provided is true and accurate.