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MEDALLION STORAGE RECEIPT - New York City 2026
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- Click ‘Get Form’ to open the MEDALLION STORAGE RECEIPT in the editor.
- Begin by entering the 'Name of Medallion Owner' in the designated field. This is crucial for identifying who is placing the medallion into storage.
- Fill in the 'Date placed into storage' by selecting the appropriate day, month, and year from the date picker.
- Input the 'Medallion No' and 'Rate Card' numbers accurately to ensure proper documentation.
- In the section labeled 'Reason for placing credentials in Storage', provide a brief explanation for why you are placing your credentials in storage.
- Complete the signature section by signing your name, printing it clearly, and adding today's date.
- If applicable, agents must submit a statement on their letterhead confirming their status as an agent for the medallion owner.
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