Reg 5045, Nonresident Military (Nrm) Vehicle License Fee Exemption Page 2

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NONRESIDENT MILITARY (NRM) VEHICLE LICENSE FEE EXEMPTION
STATE OF CALIFORNIA
SIDE B – U.S. SERVICEMEMBER SPOUSE USE ONLY (50 U.S.C. §§568, 571, 595)
DEPARTMENT OF MOTOR VEHICLES
®
A Public Service Agency
VEHICLE IDENTIFICATION NUMBER
MAKE OF VEHICLE
VEHICLE LICENSE NUMBER
To qualify for this exemption, your spouse’s duty station must be located in California and this vehicle must not be used in a trade or business.
My spouse
is on active duty in the U.S. Uniformed Services* with the
.
SPOUSE’S NAME
BRANCH OF SERVICE
My spouse is now stationed at
, California with the
.
DUTY STATION
UNIT
This can be verified by my spouse’s commanding officer, who can be reached at (
)
.
TELEPHONE NUMBER
My spouse and I are not residents of California, my spouse’s legal residence is
STATE
and my legal residence is
. NOTE: NRM exemption not applicable to California residents.
STATE
This vehicle is garaged primarily in the county of
.
COUNTY
Applicant’s Military Identification Verified
OFFICE
DATE
ID #
DMV EMPLOYEE INITIALS
*Note: 10 U.S. Code Section 101(a) defines a U.S. Uniformed Service Member as a member of the Army, Navy, Air Force, Marine Corps, Coast Guard,
the Commissioned Corps of the National Oceanic and Atmospheric Administration, and the Commissioned Corps of the Public Health Service.
THE INFORMATION YOU ARE PROVIDING IS SUBJECT TO DEPARTMENT OF DEFENSE VERIFICATION AND DMV AUDIT.
EXECUTED ON (DATE)
AT (CITY)
STATE
I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
PRINT TRUE FULL NAME
SIGNATURE
DAYTIME TELEPHONE NUMBER
X
(
)
MAILING ADDRESS
CITY
STATE
ZIP CODE
REG 5045 (REV. 4/2016) WWW
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