VS-104 Form – The VS-104 form, officially titled Certification for VERIFI Administrator Change, is an essential New York State Department of Motor Vehicles (DMV) document. It allows authorized representatives of licensed automobile dealerships to request changes to the administrator(s) who manage their facility’s access to the VERIFI system.
This form ensures secure, accurate management of electronic vehicle records. Facilities use it when adding a new VERIFI administrator or removing an existing one.
Purpose of the VS-104 Form: Certification for VERIFI Administrator Change
New York DMV designed the VS-104 specifically to update administrator details in the VERIFI system (Vehicle Electronic Reassignment and Integrated Facility Inventory). VERIFI is the official web-based platform that replaced paper-based MV-50 forms and dealer books of registry. It enables licensed dealers to electronically track vehicle inventory, sales, and ownership transfers.
Dealers must use VERIFI for all vehicle reassignments and inventory updates. Proper administrator management keeps the system compliant and prevents access issues. The VS-104 provides the certified authorization required for any administrator change.
Who Needs to File the VS-104 Form?
Only an authorized agent of a New York State licensed automobile dealership (facility) with legal authority to make changes on behalf of the dealer may complete and sign the VS-104. The form explicitly states that the requestor must certify their authority under penalty of perjury.
Important note: DMV accepts the VS-104 only for dealer certificates. Repair shop, inspection station, or other business certificates are not accepted, even if the facility number is the same.
How to Download the Official VS-104 PDF (Current Version)?
You can download the latest official VS-104 form directly from the New York DMV website:
Download VS-104 PDF here: https://dmv.ny.gov/forms/vs104.pdf
The current revision is VS-104 (3/22). The DMV continues to list and accept this form on its official Forms and Publications page as of 2026.
Step-by-Step Guide: How to Fill Out the VS-104 Form?
Follow these clear steps to complete the form correctly (print clearly or type if possible):
- Section 1 – Select the Type of Change
Check one or both boxes:- Add a new administrator → Provide: Name, Facility Number, Email address, Daytime phone number, Cell phone number.
- Remove a current administrator → Provide: Name of administrator to remove, Facility Number, Requestor’s email address, Requestor’s phone number.
- Section 2 – Complete the Certification
Print the requestor’s full name, sign the form, and enter the date (Month/Day/Year). - Read the Certification Statement
The form includes this legally binding statement: “I, the undersigned, hereby certify that I am an authorized agent of the facility with the authority to make changes to the VERIFI administrator on behalf of the facility. To knowingly make a false statement or to conceal a material fact on this form is a criminal offense…” (Penal Law § 210.45).
Tip: Double-check all facility numbers and contact information for accuracy.
How to Submit the Completed VS-104 Form?
Email the filled-out VS-104 form and any required supporting documents to:
[email protected]
The DMV instructs: “You must provide all the items and information listed below.” Submitting incomplete forms may delay processing.
Why Dealers Use the VS-104 Form (Common Scenarios)?
- Staff turnover or new hires needing VERIFI access
- Removing former employees to maintain security
- Updating contact information for the primary administrator
- Adding multiple administrators for larger dealerships
Timely updates prevent disruptions in electronic vehicle sales reporting and inventory management.
VERIFI System Overview for New York Dealers
VERIFI is the mandatory DMV system for all New York licensed automobile dealers. It electronically handles:
- Vehicle inventory tracking
- Ownership transfers (reassignments)
- Sales reporting (replacing paper MV-50s)
Registration with VERIFI is required for compliance. Proper administrator management via the VS-104 ensures your dealership stays fully operational within the system.
Important Requirements and Warnings
- The requestor must be an authorized agent with signing authority.
- False statements on the VS-104 are punishable as a criminal offense.
- Only dealer facilities qualify—other business types are rejected.
- Always use the official DMV PDF from dmv.ny.gov.
Frequently Asked Questions (FAQs) About VS-104
Q: Is the VS-104 form still current in 2026?
A: Yes. The New York DMV continues to publish and accept VS-104 (3/22) on its official website.
Q: Can I mail or fax the form?
A: No. The official instructions require email submission to [email protected].
Q: Do I need supporting documents?
A: Yes. The form states you “must provide all the items and information listed below.” Check the PDF for exact requirements.
Q: What if I need to change both add and remove an administrator?
A: You may select both options on the same form.
Related New York DMV Resources
- Official DMV Forms Page: dmv.ny.gov/forms-and-publications
- VERIFI System Website: verifiny.com
- Dealer Licensing Information: Search “dealer” on dmv.ny.gov
Download the VS-104 Form Now
Click here to download the official Certification for VERIFI Administrator Change PDF
Stay compliant and keep your dealership’s VERIFI access current. Using the official VS-104 form ensures your electronic vehicle records remain accurate and secure under New York DMV rules. If your situation involves a specific facility number or multiple changes, consult the instructions on the form or contact VERIFI support for guidance.