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VEHICLE REGISTRATION APPLICATION - Virginia

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.

to supply the required information will be denied a certificate of title and/or registration. By signing this form, you authorize DMV’s exchange of title and registration records with business, law enforcement, or government entities and you authorize DMV’s exchange of title and registration records in accordance with Va. Code §§46.2-208 ...

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Transcription of VEHICLE REGISTRATION APPLICATION - Virginia

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