FOR OFFICIAL USE ONLY - Rhode Island

1 NAME OF PERSON SUBMITTING DOCUMENTS TO DMVPRINTED NAME:SIGNATURE:LICENSE #:LICENSE STATE:TRANSACTION TYPE (PLEASE SELECT ONE)UPDATE CURRENT INFORMATION(complete sections A,B*,D,E,G)PLATE #: _____SURVIVING SPOUSE(complete sections A,D,E,F,G)PLATE #: _____RENEWAL(complete sections A,B*,D,E,G)PLATE #: _____LAST NAME (OR COMPANY NAME):FIRST NAME:MIDDLE INITIAL:SUFFIX:STREET :RESIDENCE (WHERE VEHICLE IS KEPT OR GARAGED)CITY / STATE / ZIP CODE:STREET :MAILING (IF ADDRESS IS DIFFERENT THAN RESIDENCE)CITY / STATE / ZIP CODE:LICENSE #:DATE OF BIRTH:B*. LESSEE S INFORMATION (IF VEHICLE IS LEASED)NEW REGISTRATION(complete sections A,B*,C,D,E,F,G)PLATE #: _____TRANSFER REGISTRATION(complete sections A,B*,C,D,E,F,G)PLATE #: _____DUPLICATE REGISTRATION(complete sections A,B*,D,E,G)PLATE #: _____PLATE CHANGE(complete sections A,B*,D,E,G)PLATE #: _____LAST NAME (OR COMPANY NAME):FIRST NAME:MIDDLE INITIAL:SUFFIX:LICENSE #:DATE OF BIRTH::C.

2 SELLER S INFORMATIONSELLER S NAME:STREET :CITY/STATE/ZIP CODE:DATE OF SALE:RI DEALER S LICENSE #:D. INSURANCE INFORMATIONLIABILITY INSURANCE COMPANY NAME:POLICY #:EFFECTIVE DATES (FROM and TO):PLATEPLATE DESIGNTRANSACTION #TAXFOR OFFICIAL USE ONLYE. VEHICLE INFORMATION (ALL FIELDS ARE MANDATORY)F. LIEN INFORMATION (COMPLETE IF THERE S A VEHICLE LOAN)*PLEASE CHECK THIS BOX IF THERE IS NO LIEN* (1) LIENHOLDER NAME:STREET ADDRESS:CITY / STATE / ZIP CODE:DATE OF LIEN:G. SIGNATUREI, THE UNDERSIGNED, HEREBY MAKE APPLICATION TO REGISTER THE ABOVE DESCRIBED VEHICLE AND AS PART OF MY APPLICATION DECLARE UNDER PENALTY OF PERJURY THAT I AM THE OWNER OR THE LESSEE, THAT NO OTHER LIENS EXIST AGAINST THE VEHICLE EXCEPT AS DESCRIBED HEREIN, AND THAT ALL STATEMENTS MADE ON THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF.

3 I ALSO CERTIFY UNDER PENALTY OF PERJURY THAT I HAVE READ, UNDERSTAND, AND WILL FOLLOW THE CONDITIONS CONTAINED IN THE INSURANCE COMPLIANCE STATEMENT ON THE REVERSE SIDE OF THIS :VIN (VEHICLE IDENTIFICATION #):MAKE:MODEL:BODY TYPE:GROSS VEHICLE WEIGHT:COLOR:# OF CYLINDERS:CURRENT MILEAGE:DOES VEHICLE HAVE A PICKUP BED?CAMPERS AND TRAILERS ONLYYESNONUMBER OF SEAT BELTS INVEHICLE: _____FUEL TYPE (CHECK ONLY ONE):GASHYBRIDELECTRICDIESELCNG/LPGLENGT H: _____ CARRYING CAP.: _____MOTORCYCLES/MOPEDS/SCOOTERS ONLYYESNOENGINE SIZE/CC/MPH: _____ MAX SPEED.: _____PEDALS?(2) LIENHOLDER NAME:STREET ADDRESS:CITY / STATE / ZIP CODE:DATE OF LIEN:EXCEPT AS AUTHORIZED BY LAW, THE DMV WILL NOT DISCLOSE PERSONAL INFORMATION WITHOUT YOUR YOU CONSENT TO SUCH DISCLOSURE?

4 OWNER S SIGNATURE:DATE:SECOND OWNER S SIGNATURE:IF CORPORATION, GIVE TITLE OR POSITION:IF MINOR, SIGNATURE OF PARENT OR GUARDIAN:NOTARY PUBLIC SIGNATURE:NOTARY PUBLIC NAME:DATE:COMMISSION EXPIRATION DATE (MANDATORY):APPLICATION FOR REGISTRATIONAND TITLE certificate (TR-1)STATE OF Rhode Island DIVISION OF MOTOR VEHICLES600 New London Avenue, Cranston, RI 02920-3024 Phone: 401-462-4368 S SIGNATURE MUST BE NOTARIZED IF NOT PRESENT DURING TRANSACTIONNOTARY STAMP MUST BE INK AND NOT ONLY EMBOSSEDPHONE #:CCA. REGISTRANT BUYER, LEASING COMPANY OR NEW OWNER SECOND OWNER INFORMATION, IF APPLICABLETAX & TITLE(complete sections A,B*,C,E,F,G)YESNOLAST NAME:PHONE #:FIRST NAME:EMAIL ADDRESS:TAX TOWN:LICENSE #:DATE OF BIRTH::STREET :RESIDENCE (WHERE VEHICLE IS KEPT OR GARAGED)CITY / STATE / ZIP CODE:EMAIL ADDRESS:TAX TOWN:TYPE,03257$17 ,1)250$7,21 The law prohibits the registration of a vehicle in the name of a person under sixteen (16) years of age.

5 The law requires a person over sixteen(16) years of age to establish evidence of financial responsibility with the Division of Motor Vehicles and to file with the Division a certificate of consent approved by parents or legal guardian before registration can be issued unless special approval is obtained from theDivision. Registration card shall, at all times, be carried in the vehicle to which it refers or shall be carried by the person driving or in control of such vehicle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

6 PDLQWDLQLQJ DQ RZQHU V SROLF\ RI OLDELOLW\ LQVXUDQFH ZLWK PLQLPXP ERGLO\ LQMXU\ OLPLWV RI WR DQ\ RQH SHUVRQ DQG WR WZR RU PRUH SHUVRQV LQ DQ\ RQH DFFLGHQW DORQJ ZLWK D OLPLW RI IRU LQMXU\ WR RU GHVWUXFWLRQ RI SURSHUW\ RI RWKHUV LQ DQ\ RQH DFFLGHQW RU D FRPELQHG ERGLO\ LQMXU\ DQG SURSHUW\ GDPDJH OLPLW RI ILOLQJ D ILQDQFLDO VHFXULW\ ERQG ILOLQJ D ILQDQFLDO VHFXULW\ GHSRVLW LQ WKH DPRXQW RI RU TXDOLI\LQJ DV D VHOI LQVXUHU )DLOXUH WR FRPSO\ ZLWK WKH $FW PD\ UHVXOW LQ WKH LPSRVLWLRQ RI ILQHV DQG RU WKH VXVSHQVLRQ RI \RXU OLFHQVH DQG UHJLVWUDWLRQ V 7KH H[LVWHQFH RI WKH $FW GRHV QRW SUHYHQW WKH SRVVLELOLW\ WKDW \RX PD\ EH LQYROYHG LQ DQ DFFLGHQW ZLWK DQ RZQHU RU RSHUDWRU RI D PRWRU YHKLFOH ZKR LV QRW FRYHUHG E\ LQVXUDQFH &5$16721 )D[ 1 XPEHUV RU 6863(16,216 (0,66,216 &+,/' 6833257 $'-8',&$7,21401-458-4400 (phone) 401-462-0800 (phone) ID[ 401-462-5890 (phone) 401-462-5838 (fax) ,1 %/2CK 401-574-8941 (phone) 401-574-8863 (phone))25 (1)25&(0(17 2)),&( 21/< ,'(17,7< BBBBBBBBBBBBBBBBBBBBBBBBBBBBBB 3 2 5 BBBBBBBBBBBBBBBBBBBBBBBBBBBBBB 6 6 &$5' BBBBBBBBBBBBBBBBBBBBBBBBBBBBBB 27+(5 BBBBBBBBBBBBBBBBBBBBBBBBBBBBBB67$03 9$/,' 7,/ _____ DATE'09 2)),&,$/ BBBBBBBBBBBBBB (0$,/ $''5(66(6 '09 &86720(5 6(59,&( (0$,/ '09 &XVWRPHU6 HUYLFH#GPY UL JRY7R EH XVHG RQO\ IRU HPDLOLQJ VXSSRUWLQJ GRFXPHQWV 3 OHDVH XVH WKH )))))))]]]

7 HHGEDFN 4 XHVWLRQV 7DE RQ WKH ULJKW VLGH RI WKH '09 V KRPH SDJH IRU DQ\ RWKHU '09 TXHVWLRQV RU LQTXLULHV $'-8',&$7,21 (0$,/ GPY DGM#GPY UL JRY3 OHDVH VHQG DQ HPDLO LQFOXGLQJ \RXU QDPH GDWH RI ELUWK OLFHQVH QXPEHU DQG D EULHI GHVFULSWLRQ RI \RXU LVVXH DQG DQ $SSHDOV 2 IILFHU ZLOO UHVSRQG WR \RXU LQTXLU\ 3 OHDVH XVH WKH )HHGEDFN 4 XHVWLRQV 7DE RQ WKH RQ WKH ULJKW VLGH RI WKH '09 V KRPH SDJH IRU DQ\ RWKHU '09 TXHVWLRQV RU LQTXLULHV ),1$1&,$/ 5(63216,%,/,7<401- - (phone) ID[ 2)),&,$/ 86( 21/< TOLL EVADER401-423-0800 (phone) Rhode Island DMV Document Checklist REGISTRATION rev. 11/13 Dealer Sale Private Party Sale Plate Change Renewal / Re-Registration Out-of-State Transfer TR-1 form Insurance Information (valid RIinsurance) Registration certificate (s) RI license or identification card Plates to be canceled TR-1 form Insurance Information (valid RIinsurance) Proof of Ownership (original title orprevious registration) RI license or identification card Plate number (if available)Surviving SpouseDuplicate Registration certificate TR-1 form Insurance Information (valid RIinsurance) Dealer Sales Tax form Bill of Sale Gross Vehicle Weight RI license or identification card RI Use Tax form (out-of-state dealersonly) Power of Attorney (if leased vehicle)]

8 If two owners on title, both parties mustbe present during registration, if not,signature of the absent party must benotarized on TR-1 And the following: Manufacturer s Statement of Origin(MSO) or original title (if model year ofvehicle is 2001 or newer) VIN check if original title is fromanother state (if model year of vehicleis 2001 or newer) TR-1 form Insurance Information (valid RIinsurance) Sales Tax form Original title (if model year ofvehicle is 2001 or newer) VIN check if original title is fromanother state (if model year ofvehicle is 2001 or newer) Bill of Sale Gross Vehicle Weight RI license or identification card Proof of Previous Owner (non-titledvehicles) Gift letter (notarized if vehicle giftedis from a non-immediate familymember)

9 If two owners on original title, bothparties must be present duringregistration, if not, signature of theabsent party must be notarized onTR-1 Name ChangeAddress Change TR-1 form Insurance Information (valid RIinsurance) RI license or identification card (withupdated name) Original title (if model year of vehicle is2001 or newer) TR-1 form Insurance Information (valid RIinsurance) Change of Address Card (if by mail) RI license or identification card TR-1 form Original title, in name ofdeceased (if model year ofvehicle is 2001 or newer) Current registration Death certificate (original) Insurance Information (valid RIinsurance) RI license or identification card TR-1 form Insurance Information (valid RIinsurance) RI license or identification card Plate number (if available) TR-1 form Insurance Information (valid RIinsurance) Original title - if model year ofvehicle is 2001 or newer) Out-of-State leased vehicletransfers require an original title,if no loan.

10 A photocopy of a titlefor a leased vehicle will beaccepted ONLY if lienholder islisted on the original title. VIN check (if model year ofvehicle is 2001 or newer)(for VIN check locations, pleasecontact your local policedepartment) Tax exempt card Tax questionnaire (Bill of Sale, ifapplicable) RI license or identification card (ifout-of-state license is presented,proof of residency is additionallyrequired) Proof of Ownership (non-titledvehicles) Power of Attorney (if leasedvehicle) If two owners on original title,both parties must be presentduring registration, if not,signature of the absent partymust be notarized on TR-1 Identity documents (legal name and date of birth) Rhode Island license or identification card or valid out-of-state licenseProof of Residency Within 60 Days Utility bill (gas, electric, telephone, cable, oil)