DS-21 Form – The DS-21 Form, officially titled “Department of Motor Vehicles Ordered Interlock Device Installation Confirmation,” is a required New York State DMV document used to verify the proper installation of an ignition interlock device (IID). This form confirms that a certified device has been installed in all vehicles a motorist owns or operates, as mandated by court order following certain DWI convictions.
It serves as official proof for the New York DMV that the interlock requirement has been met, allowing the driver to obtain or reinstate a New York State driver license with the mandatory “Problem Driver Interlock Restriction.” The form is still current as of 2026 and available directly from the official NY DMV website.
Why Is the DS-21 Form Required Under New York’s Ignition Interlock Program?
New York’s ignition interlock program stems from Leandra’s Law, enacted in 2009 to strengthen penalties for drunk driving. Since August 15, 2010, anyone convicted of Driving While Intoxicated (DWI) must have an ignition interlock device installed on every vehicle they own or operate. The DS-21 Form provides the DMV with documented confirmation of installation so the interlock restriction can be added to the driver’s license record.
Without a completed DS-21, drivers cannot receive the restricted license needed to legally operate a vehicle equipped with the device. The restriction appears on the back of the physical license as “interlock device” and remains in effect even if the license was previously revoked. This form is a critical step in complying with court-ordered probation or conditional discharge requirements.
Who Must Submit the DS-21 Form?
The DS-21 Form is required for any motorist ordered by a New York court to install an ignition interlock device. This typically includes:
- Drivers convicted of standard DWI (minimum 6 months of interlock use).
- Drivers convicted of Aggravated DWI (BAC of 0.18 or higher) or DWI with a child in the vehicle (minimum 12 months of interlock use).
Courts and probation departments direct convicted drivers to approved vendors for installation. Once the device is installed, the DS-21 must be completed before the motorist can visit a DMV office to obtain the restricted license.
Note: The form applies to all personally owned or operated vehicles (excluding vehicles driven solely for employment). You must list every applicable vehicle on the DS-21.
Step-by-Step Guide: How to Complete the DS-21 Form
Completing the DS-21 Form is straightforward and divided into two sections. Here’s exactly how it works, based on the official form instructions:
Motorist Section (Completed by You)
- Provide your full name, address, date of birth, and NYS Client ID number.
- List all vehicles you personally own or operate (year, make, model, and VIN). Do not include work vehicles.
- Present a valid NYS Non-Driver ID Card or other government-issued photo ID to the installer at the time of installation.
- Sign the certification statement confirming you understand the interlock requirement applies to any future vehicles you may obtain and that all information is true.
Installer Section (Completed by the Certified Installer)
- The installer records the installation date and the specific Ignition Interlock Device Model used.
- The device must be certified by the NYS Department of Health and approved by the NYS Division of Criminal Justice Services (DCJS).
- The installer confirms that all vehicle operators have been trained on proper use and maintenance.
- The installer signs and dates the form.
Important Warning on the Form: Making a false statement or deceiving anyone in connection with the DS-21 can result in criminal prosecution (misdemeanor or felony) under New York Vehicle & Traffic Law and/or Penal Law.
Where and How to Submit the Completed DS-21 Form?
After installation:
- The installer must immediately fax or email a copy of the completed DS-21 to the New York DMV at (518) 473-8229 or [email protected].
- The installer returns the original completed form to the motorist.
- The motorist must bring the original DS-21 (plus all other required paperwork) to any New York DMV office to apply for the license with the Problem Driver Interlock Restriction.
DMV offices will verify the installation before issuing the restricted license. Always check dmv.ny.gov for current office hours and appointment requirements.
Downloading the Official DS-21 Form
You can download the latest DS-21 Form directly from the New York DMV website here:
https://dmv.ny.gov/forms/ds21.pdf
The form is labeled DS-21 (3/15) and remains the current version used statewide. Always use the official PDF from dmv.ny.gov to ensure compliance.
How the DS-21 Form Fits Into the Full Ignition Interlock Process?
- Court conviction and sentencing (probation or conditional discharge with interlock order).
- Court or probation directs you to an approved interlock vendor.
- Device installation on all required vehicles.
- Installer completes and submits DS-21 Form.
- You visit DMV with DS-21 to receive restricted license.
- Device remains installed for the full court-ordered period (6 or 12 months minimum).
- At the end of the required period, your interlock monitor notifies DMV electronically to lift the restriction (no paper forms accepted for removal).
Approved devices and vendor lists are maintained by the NYS Division of Criminal Justice Services and updated regularly (latest qualified manufacturer list effective January 2026).
Frequently Asked Questions About the DS-21 Form
Can I install the device myself?
No. Only certified installers from approved vendors may complete the DS-21 Form.
What if I buy or lease a new vehicle later?
You must have the interlock installed on the new vehicle and may need to submit an updated DS-21 or follow your monitor’s instructions.
Is the DS-21 Form free?
The form itself is free to download, but interlock installation and monthly monitoring fees apply (paid directly to the vendor).
How long does the interlock restriction stay on my license?
It remains until your court-ordered period ends and the monitor electronically notifies DMV.
Where can I find approved interlock vendors?
Visit the official DCJS Ignition Interlocks page for current provider locations and manufacturer information.
Tips for Smooth DS-21 Compliance and License Restoration
- Schedule installation immediately after court direction to avoid delays in obtaining your restricted license.
- Bring proper photo ID to the installer.
- Keep a copy of the DS-21 for your records.
- Contact your probation officer or interlock monitor with any questions about compliance.
Following the DS-21 process correctly helps you stay compliant with Leandra’s Law, avoid additional penalties, and safely regain driving privileges with the required interlock restriction.
For the most up-to-date information, always refer to the official New York DMV website at dmv.ny.gov or contact your local DMV office. Safe driving starts with full compliance.