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VEHICLE REGISTRATION APPLICATION - DMV

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.

If I/we have requested Amateur Radio Operator Call Letter license plates, I/we certify and affirm that I/we will return those plates to DMV for another type of license plate within 90 days if my/our amateur radio license becomes invalid for any reason. An authorized representative must sign for a corporation or company.

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  Operator, Amateur

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