Form Reg 343 - Application For Title Or Registration Page 2
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1
2VERIFICATION OF VEHICLE
NOT TO BE COMPLETED BY APPLICANT
A Public Service Agency
This form must be completed in full by an authorized DMV representative, California licensed vehicle verifi er, authorized auto
club, or peace offi cer who has been properly trained to perform vehicle verifi cations.
WARNING
: Alterations or erasures will void this form. Your vehicle may also be subject to verifi cation by the California
Highway Patrol.
LICENSE PLATES ON VEHICLE
LICENSE PLATE NUMBER
STATE
EXP. DATE
None
Dealer
Temporary Permit
VEHICLE IDENTIFICATION NUMBER (VIN)
ENGINE NUMBER (MOTORCYCLES ONLY)
MAKE
BODY TYPE
MODEL YEAR
AXLES
MOTIVE POWER (FUEL)
EST. WEIGHT (TRAILERS)
MODEL OR SERIES
NUMBER OF WHEELS
FOR CMP/CCH/MTRHM
Length_________ Width_________
VIN Location:
Attached by:
Visible through windshield
Trunk
Not visible
Adhesive
Body—Left (driver side)
Frame
Rosette rivets
Not applicable
Body—Right
Other: _______________
Round rivets
Other: _______________
Engine compartment
Screws
Type:
Stamped on Frame
Metal plate
Label
Stamped on body
Other: ____________________________________________
VIN/ENGINE NUMBER (IF MOTORCYCLE, MARK BOTH VIN AND ENG. BOXES)
VIN ENG
VIN ENG
VIN ENG
VIN ENG
Appears okay
Illegible/Damaged
Cannot locate
Assigned by F/O
Altered/Tampered
Missing
None—Newly built
See REMARKS
US FEDERAL CERTIFICATION LABEL STATUS:
US FEDERAL CERTIFICATION LABEL (1970 AND SUBSEQUENT YEAR MODELS):
Agrees with VIN
Missing
Vehicle complies with US Federal Motor Vehicle Safety Standards (US FMVSS)
Disagrees with VIN
None—NA
Label indicates name of vehicle importer (enter name of importer in “REMARKS” below)
Illegible/Damaged
See REMARKS
Vehicle complies with safety requirements of a country other than US
miles
5-digit odometer
ODOMETER MILEAGE READING
,
.
kilometers
6-digit odometer
(no
record mileage exactly as shown on vehicle odometer
tenths)
10
digital display
SUPPORTING DOCUMENTS:
Agrees with VIN
No VIN on documents
See REMARKS
Disagrees with VIN
None
EMISSION LABEL INDICATES:
Vehicle meets US EPA standards only
Vehicle meets California standards only
Vehicle meets US EPA standards and California standards
Vehicle meets California standards for off highway vehicles
Engine displacement less than 50 cubic centimeters
None
See REMARKS
REMARKS
DO NOT PROCESS - REFER TO CHP
I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
I further certify that I examined the vehicle described above and I fi nd the description of the vehicle to be as indicated.
VERIFIER (PLEASE PRINT)
TITLE/BADGE/ID NUMBER
ADDRESS
CITY
STATE
VERIFIED AT
CITY
STATE
Above address
Other (specify)
VERIFIER’S SIGNATURE (STAMPED NAMES/SIGNATURES WILL NOT BE ACCEPTED)
EXECUTED AT CITY
STATE
DATE
X
VERIFYING AGENCY
DAYTIME TELEPHONE NUMBER
(
)
DMV
Vehicle Verifi er
Auto Club
Peace Offi cer (specify):
STATEMENT OF FACTS — IDENTIFICATION NUMBER OR ENGINE NUMBER ERROR
I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct. I
further certify that I am the owner of above described vehicle and had no knowledge of the difference in the identifi cation or
engine number on the vehicle and titling documents.
VEHICLE OWNER’S SIGNATURE
DATE
X
REG 343 (REV. 2/2007) REG 343/REG 31 COMBINED WWW
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