Transcription of OREGON COMMERCIAL REGISTRATION APPLICATION
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OREGON COMMERCIAL REGISTRATION APPLICATION
PLATE NUMBER (IF ANY)VTMAKEYEARCOMPLETE VEHICLE IDENTIFICATION NUMBERFUELUNIT NUMBEROWNEDLEASEDLESSORTAX DECLARED WEIGHTS:SOLOAXLCOMB #1 AXLCOMB #2 AXLCOMB #3 AXLCOMB #4 AXLODOMETERHUBKMFEE BASISBODYREGISTRATION WEIGHTANNUAL JAN 1-DEC 311ST QTR JAN 1-MAR 312ND QTR APR 1-JUN 303RD QTR JUL 1-SEP 30 VEHICLE AMENDMENT:UNIT NUMBERWEIGHTVEHICLE TYPEOTHER:ODOTONLY USE REGISTRATION FEE4TH QTR OC 1-DEC 31 HEAVY VEHICLE USE TAX (ATTACH PROOF OF PAYMENT)DEQ (ATTACH CERTIFICATE)CREDENTIAL FEEYESNOIF NO, ENTER THE USDOT OF THE CARRIER RESPONSIBLE FOR SAFETY OF THE ABOVE NUMBERFAX NUMBER OR EMAILCCD ACCOUNT NUMBERSUBBUSINESS NAMEEFFECTIVE DATEADDRESSCITYSTATEZIP CODEPLATE MAILING ADDRESS (IF DIFFERENT FROM ABOVE)CITYSTATEZIP CODEOREGON REGISTRATION DISCONTINUED OR CANCELLEDDO NOT WRITE IN SPACE ABOVEOREGON
3930 FAIRVIEW INDUSTRIAL DRIVE SE SALEM OR 97302-1166 PH (503) 378-6699 FAX (503) 378-6880 . Under Oregon law, it is a crime to knowingly provide false information or certify any information that a person knows to be false related to a vehicle registration (ORS 803.375 and 803.385). Each offense is a
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