Transcription of VEHICLE REGISTRATION APPLICATION
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VEHICLE REGISTRATION APPLICATION
VSA 14 (07/10/2018)LESSEE'S RESIDENCE/BUSINESS ADDRESSCITYZIP CODESTATELESSEE'S FULL LEGAL NAME (last, first, mi, suffix)DMV CUSTOMER NUMBER / FEIN / SSNTELEPHONE NUMBERLEASE INFORMATION (if applicable) REGISTRATION MAILING ADDRESS - OPTIONALCITYZIP CODESTATEIF YOU WOULD LIKE YOUR REGISTRATION RENEWALS SENT TO AN ADDRESS OTHER THAN YOUR RESIDENCE/BUSINESS ADDRESS, ENTER IT NEW LOCATION ENTER DATE CHANGEDAre any of the owners/lessees on active military duty or service?YESNOLOCATION WHERE VEHICLE IS PRINCIPALLY GARAGEDTOWN OFCITYCOUNTYVEHICLE INFORMATION OWNER EMAIL ADDRESSCO-OWNER EMAIL ADDRESSOWNER'S RESIDENCE/HOME/BUSINESS ADDRESS (Apt # if applicable)CITYZIP CODESTATECITYZIP CODESTATECO-OWNER'S RESIDENCE/HOME/BUSINESS ADDRESS (Apt # if applicable)NOTE: Owners (and Lessees if applicable) MUST provide their residence/home/business address where requested, this address can not be a Box.
This vehicle is not insured; therefore, I am remitting the applicable uninsured motor vehicle fee. (This fee provides no insurance coverage.) A vehicle must be insured with liability coverage when it is registered, and it must remain insured while registered, whether or not it is operated, or the uninsured motor vehicle fee must be paid.
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