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Application For Tinted Window Exemption

Page 1 of 2 Application FOR Tinted Window EXEMPTIONP rovide the following information as it appears on the vehicle a medical Exemption is requested for someone other than the registered owner of the vehicle, please provide thefollowing information about that 375(12-a)(b) of the Vehicle and Traffic Law provides that the front windshield and side windowson both sides of anyeligible vehicle that is operated in New York State must allow at least 70% of any light to pass through. The rearwindow mayallow less than 70% of any light to pass through if the vehicle has mirrors on both sides that can be adjusted so the driver has aclear view of the road and traffic conditions behind the vehicle.

PHYSICIAN’S STATEMENT FOR TINTED WINDOW EXEMPTION. This side must be completed by your physician/physician assistant/nurse practitioner. 1. Examination Date / / (Must be within one year from the date this form is submitted to the Department of Motor Vehicles.) 2. The following medical conditions, when their existence is certified by a ...

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