CERTIFICATE OF NON-OPERATION - VCVRS

1 ADDRESSCITYSTATEZIP CODETHE VEHICLE(S) LISTED BELOW WAS (WERE) STOREDCERTIFICATE OF NON-OPERATIONI have knowledge that the vehicle(s) listed below was/were not driven, moved, towed or left standing (parked) upon any Californiahighway so as to cause registration fees to become due, nor transported over any California public highway or operated so asto cause off-highway vehicle identification fees to become due. If required, a Statement of Planned NON-OPERATION is on certify under penalty of perjury under the laws of the State of California that the foregoing is true and ID NO.(Last 3 digits)REG 102 (REV. 9/2005) WWWXA Public Service AgencyFROM:MONTHDAYYEARTO:MONTHDAYYEARAT THE FOLLOWING LOCATION:DATESIGNATUREDAYTIME TELEPHONE NO.

2 ( )LICENSE PLATE (OFF HIGHWAYVEHICLE)VEHICLE LICENSEVEHICLE ID NUMBEREQUIPMENTPLATE NUMBER(LAST 3 DIGITS)NUMBERMAKEVEHICLE*I certify under penalty of perjury under the laws of the State of California that the information I have provided is true 102 (REV. 9/2005) WWWA Public Service AgencyPLANNED NON-OPERATION CERTIFICATIONThe vehicle(s) listed below will not be operated, moved, towed or left standing (parked) upon any California highway so as to causeregistration fees to become due, nor transported over any California public highway or operated so as to cause off-highway vehicleidentification fees to become due. If there is any change in the operation status, appropriate renewal fees will be paid prior TELEPHONE NO.

3 ( )Department of Motor Vehicles, Box 942869, Sacramento, CA 94269-0001*NOTE: A PENALTY IS DUE, IF FILED AFTER THE VEHICLE REGISTRATION EXPIRATION DATE. THE APPLICABLE BOX9