PUBLIC EMISSIONS INSPECTION
                                                                                                     STATION BUY/SELL AGREEMENT
                       *Enclose this form with the Original Facility Application submitted by the purchaser*
          In order for DMV to accept for review a buy/sell agreement for an official public emissions group 1a inspection station, the
          selling facility and the purchasing facility must be in the same county or within five miles of each other.  Additionally, the selling
          facility must be in good standingŽ at the time of sale. Good standingŽ means that:
                    - the facility license is valid and is not suspended or revoked,
                    - the facility does not owe any outstanding civil penalties,
                    - the facility has no hearings or appeals pending before the DMV, and
                    - the facility has no litigation pending in which the DMV is named as a party.
          The selling facility must also be able to account for all unused inspection certificates (stickers).  
          If inspection certificates are missing, there may be long delays in processing the buy/sell agreement, denial of the 
          application, or possible administrative action.
           Selling Facility Information:
           Facility Number:                                                                       County:  
           Facility Name:    
           Facility Address: 
           Daytime Contact Phone: (             )              -                        Alternate Contact Phone: (             )             -
           NYVIP Unit Number : NY
            A copy of your current inspection license issued by DMV must be attached.
            I/we understand that if DMV approves the original facility application for a public emissions inspection station that was
            submitted by the purchaser, the inspection license for the selling facility will be placed out of business.  If the
            purchasing facility is approved at the same location as the selling facility, all business types for the selling 
            facility will be placed out of business. After being placed out of business, if I/we wish to become a public emissions
            inspection station in the future, I/we would be required to submit an original application.  If I/we apply to become a 
            public emissions inspection station, the application will be for a new license and, as such, may be subject to placement
            on a waitlist, as required by 15 NYCRR 79.7 (f).
           I/we, the undersigned, sold or agree to sell the facility below.
           I/we understand that 
                                                                                      (name of purchaser)
           is applying to DMV to acquire approval to operate a public emissions group 1a inspection station.
                                                                                Date of agreement/sale:                /               /
                                                                                                                (mm)        (dd)           (yyyy)
           ALLprincipals of the selling facility on record with DMV must sign below (attach additional notarized sheet(s) if necessary):
           IMPORTANT: This form must be notarized within 90 days prior to receipt by DMV.
                      Print Name                            Title(s)                    Date of Birth                        Signature
                                                                                          /        /
           Sworn to and signed before me this                                 day,                        Notary Stamp Below
           in the year of                                   .
                                       (Notary Public)
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                                                    Facility Name:    
                  Print Name                     Title(s)               Date of Birth                  Signature
                                                                         /        /
         Sworn to and signed before me this                    day,                    Notary Stamp Below
         in the year of                                   .
                                (Notary Public)
                  Print Name                     Title(s)               Date of Birth                  Signature
                                                                         /        /
         Sworn to and signed before me this                    day,                    Notary Stamp Below
         in the year of                                   .
                                (Notary Public)
                  Print Name                     Title(s)               Date of Birth                  Signature
                                                                         /        /
         Sworn to and signed before me this                    day,                    Notary Stamp Below
         in the year of                                   .
                                (Notary Public)
                  Print Name                     Title(s)               Date of Birth                  Signature
                                                                          /        /
         Sworn to and signed before me this                    day,                    Notary Stamp Below
         in the year of                                   .
                                (Notary Public)
                                  *This form must be notarized within 90 days prior to receipt by DMV.
         Purchaser Information:
         Name:                                                    Daytime Contact Phone: (         )        -
         Contact Address: 
         Facility Number (if applicable): 
        Computerized Vehicle Inspection System (CVIS):
        In addition to transferring the facility licenses and certificates, every official public emissions station needs to have a CVIS.
        The current provider of the CVIS in New York State is Opus Inspection.  Please contact them regarding transferring equipment
        or an original equipment purchase at (866) 623-8378 or at www.nyvip.org.
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