New York Vehicle & Traffic Law
Certificate of Magistrate
(a) Upon the suspension or revocation of any license or certificate of registration for any reason specified in sections five hundred ten and eleven hundred ninety-three of this chapter as a ground for such suspension or revocation, the magistrate or other officer suspending or revoking the same shall, within ninety-six hours, transmit to the commissioner a certificate stating:
(a) whether such license or certificate has been suspended or revoked and, if suspended, the period of such suspension;
(b) the name and address of the person whose license or certificate has been suspended or revoked;
(c) the nature of the offense committed, or other reason for the suspension or revocation;
(d) the number and character of the violations of the provisions of this chapter, or of any lawful local ordinance, rule or regulation in relation to motor vehicle or motorcycle speed or traffic, of which such licensee has been convicted, so far as practicable. Such certificate shall be presumptive evidence of the facts recited therein. At such time, said magistrate or officer shall transmit such license, if surrendered at sentencing, to the commissioner.
(b) Where a person has been granted youthful offender status, the certificate required by subdivision (a) of this section shall specify (i) whether such license or certificate has been suspended or revoked, and if suspended, the period of such suspension; if revoked, the time period within which no new license may be issued;
(ii) the name and address of the person whose license or certificate has been revoked; and
(iii) such other information as the commissioner may require by regulation.