Application for Title or Registration (REG 343)

1 1. OWNER INFORMATION (Please print true full name or lessor/business name)2. Title HOLDER INFORMATION (Do NOT reenter owner s name) If NONE, so AND OPERATION INFORMATION (Purchase price does not include sales tax, insurance, finance charges, or warranty.)4. OWNER(S) SIGNATURE(S)DATE VEHICLE ENTERED OR WAS FIRST OPERATED IN CALIFORNIADATE YOU WENT TO WORK IN CALIFORNIA OR BECAME A RESIDENT (WHICHEVER OCCURRED FIRST)VEHICLE WAS PURCHASED OR ACQUIRED ON:AND WAS (CHECK ONE BOX):YEAR MODELVEHICLE WAS PURCHASED OR ACQUIRED FROM:MUST CHECK ONE BOX ONLY, AND ENTER REQUIRED INFORMATION FOR THAT ONE BOX: Application FORTITLE OR REGISTRATIONMo. _____ Day _____ Yr. _____Mo.

2 _____ Day _____ Yr. _____Mo. _____ Day _____ Yr. _____ NewUsedDealerFamily MemberPrivate PartyX( )X( )LAST NAME OR LESSOR OR BUSINESS NAMEFIRST NAMEMIDDLE NAMECALIFORNIA DRIVER LICENSE OR ID NUMBERLAST NAME, OR LESSEEFIRST NAMEMIDDLE NAMECALIFORNIA DRIVER LICENSE OR ID NUMBERLAST NAME, OR LESSEEFIRST NAMEMIDDLE NAMECALIFORNIA DRIVER LICENSE OR ID NUMBERRESIDENCE OR BUSINESS ADDRESS (Include St., Ave., etc.) CODEMAILING ADDRESS (If Different From Above) CODELESSEE ADDRESS (If Different From Above) CODETRAILER COACH ONLY ADDRESS WHERE TRAILER IS LOCATED (If Different From Above)CITYSTATEZIP CODEO/S DL #/STATETECH INITIALSVEHICLE/HULL IDENTIFICATION NUMBERMAKE OF VEHICLE OR VESSEL BUILDEROWNER S SIGNATUREEXECUTED ATCITYSTATEDATEDAYTIME TELEPHONE NUMBEROWNER S SIGNATUREEXECUTED ATCITYSTATEDATEDAYTIME TELEPHONE NUMBERREG 343 (REV.)

3 4/2006) REG 343/REG 31 COMBINED WWWNAME OF BANK/FINANCE COMPANY OR INDIVIDUALELECTRONIC Title NUMBERBUSINESS OR RESIDENCE CODEMAILING ADDRESS (If Different From Above ) CODEA. Will this vehicle be used to carry people for hire (taxi, bus, etc.)? ..YesNoB. When you acquired this vehicle were you on active duty in the Armed Forces? ..YesNoIf yes, print name of state or country where stationed: _____C. Is this a commercial motor vehicle that operates at 10,001 lbs. or more (pickups excluded)? ..Yes NoIf yes, a Declaration of Gross Vehicle Weight/Combined Gross Vehicle Weight Form (REG 4008) must be yes, a Motor Carrier Permit may be required. Call (916) 657-8153 for further Was sales tax paid to another state?

4 YesNo If yes, enter amount paid: $ _____If your car was last registered in another state, you may be eligible for a use tax exemption. For further information please contact the Boardof Equalization or visit USE ONLY The registered owner mailing address is valid, existing, and an accurate mailing address. I consent to receive service of process at thismailing address pursuant to VC certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. ,.10is theis not themileage exceeds the (no tenths) mileageactual mileageodometer mechanical limitANDORANDORMILES/KILOMETERS: If new owner, enter miles at date of purchase and check here.

5 If no change of ownership, enter miles as of this date and check here..A Public Service AgencyI purchased this vehicle for the price of $ acquired this vehicle as a gift or trade. Its value when I acquired it was $ acquired this vehicle as a gift or trade. Its current market value is $ _____. (Requires completed Statement of Facts [REG 256].)LICENSE PLATES ON VEHICLELICENSE PLATE NUMBERSTATEEXP. DATEVEHICLE IDENTIFICATION NUMBER (VIN)ENGINE NUMBER (MOTORCYCLES ONLY)MAKEBODY TYPEMODEL YEARAXLESMOTIVE POWER (FUEL)EST. WEIGHT (TRAILERS)MODEL OR SERIESNUMBER OF WHEELSFOR CMP/CCH/MTRHMVIN/ENGINE NUMBER (IF MOTORCYCLE, MARK BOTH VIN AND ENG. BOXES)US FEDERAL CERTIFICATION LABEL STATUS:US FEDERAL CERTIFICATION LABEL (1970 AND SUBSEQUENT YEAR MODELS):SUPPORTING DOCUMENTS:EMISSION LABEL INDICATES.

6 REMARKSVERIFIER (PLEASE PRINT) Title /BADGE/ID NUMBERADDRESSCITYSTATEVERIFIED ATCITYSTATEVERIFIER S SIGNATURE (STAMPED NAMES/SIGNATURES WILL NOT BE ACCEPTED)EXECUTED ATCITYSTATEDATEVERIFYING AGENCYVEHICLE OWNER S SIGNATUREEXECUTED AT CITYSTATEDATEV ehicle meets US EPA standards onlyVehicle meets California standards onlyVehicle meets US EPA standards and California standardsVehicle meets California standards for off highway vehiclesEngine displacement less than 50 cubic centimetersNoneSee REMARKSA grees with VINNo VIN on documentsSee REMARKSD isagrees with VINNoneVIN ENGVIN ENGVIN ENGVIN ENGA ppears okayIllegible/DamagedCannot locateAssigned by F/OAltered/TamperedMissingNone Newly builtSee REMARKS VIN Location:Attached by.

7 Visible through windshieldTrunkNot visibleAdhesiveBody Left (driver side)FrameRosette rivetsNot applicableBody RightOther: _____Round rivetsOther: _____Engine compartmentScrewsXDMVV ehicle VerifierAuto ClubPeace Officer (specify):XSTATEMENT OF FACTS IDENTIFICATION NUMBER OR ENGINE NUMBER ERRORI certify under penalty of perjury that I am the owner of above described vehicle and had no knowledge of the difference in theidentification or engine number on the vehicle and titling with VINM issingVehicle complies with US Federal Motor Vehicle Safety Standards (US FMVSS)Disagrees with VINNone NALabel indicates name of vehicle importer (enter name of importer in REMARKS below)Illegible/DamagedSee REMARKSV ehicle complies with safety requirements of a country other than USType:Stamped on FrameMetal plateLabelStamped on bodyOther.

8 _____I certify under penalty of perjury under the laws of the State of California that I examined the vehicle described above and I findthe description of the vehicle to be as Public Service AgencyODOMETER MILEAGE READING record mileage exactly as shown on vehicle odometerREG 343 (REV. 4/2006) REG 343/REG 31 COMBINED WWWVERIFICATION OF VEHICLENOT TO BE COMPLETED BY APPLICANTThis form must be completed in full by an authorized DMV representative, California licensed vehicle verifier, authorized autoclub, or peace officer who has been properly trained to perform vehicle :Alterations or erasures will void this form. Your vehicle may also be subject to verification by the CaliforniaHighway addressOther (specify)NoneDealerTemporary PermitDO NOT PROCESS - REFER TO CHP Length_____ Width_____.

9 Miles5-digit odometerkilometers6-digit odometerdigital display(notenths)10