Sample Receipt Form (PSB-2) - New York State DMV - dmv ny 2026

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The document is a sample receipt form required by Commissioner’s Regulations for Private Service Bureaus, detailing the necessary components for issuing receipts for services rendered. It includes sections for business information, customer details, services provided with associated fees, and a total amount received. The form emphasizes that the bureau is licensed but not an official DMV agency.

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Click ‘Get Form’ to open the Sample Receipt Form (PSB-2) in our editor.
Begin by entering your business name and address at the top of the form. Ensure that all details are accurate for proper identification.
Fill in the receipt number and date fields. This is crucial for record-keeping and tracking purposes.
In the 'Received from' section, input the customer's name and address. This information is essential for validating the transaction.
List the services provided along with their respective fees. Be sure to include any DMV fees as well as your service charges.
Calculate the total amount received from the customer, ensuring it includes all listed fees, and enter this in the designated field.
Finally, sign off on the receipt by filling in 'Received by' with your name or authorized representative's name.

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