Get NY AA-137 2010
Ent of Motor Vehicles, SAFETY HEARING BUREAU, 6 Empire State Plaza, Room 312, Albany, New York 12228-0312. Motorist's Last Name First M.I. Date of Birth (MM/DD/YYYY) / Motorist's Street Address (include Street Number and Name, Rural Delivery Box and (or Apartment Number). City Male / Zip Code State Date of Alleged Refusal / Location of Refusal / Arresting officer Telephone Number (Area Code) Police Agency ( Court Name Arraignment Date / Female Ticket Number ) Street Tax Reg.
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