Form Mvd - 10208 - Request For Refund Form - Village Of Hatch
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1MVD - 10208
CHECK ONE:
STATE OF NEW MEXICO - MOTOR VEHICLE DIVISION
REV.
02/03
❑
REQUEST FOR REFUND
Vehicle Related
❑
Driver Related
OWNER / DRIVER INFORMATION
Printed Name
Date of Birth
Address
Social Security Number
City, State, Zip Code
Driver License Number
Citation Number
Telephone No. (
)
(If Applicable)
VEHICLE / VESSEL INFORMATION (IF APPLICABLE)
Year
Make
Model
Body Type (Series)
State Registered
Engine No. (If Applicable)
Vehicle or Hull ID Number
License Plate or Boat No.
REASON(S) FOR REFUND
VEHICLE RELATED
DRIVER RELATED
❑
INCORRECT COMPUTATION OF REGISTRATION FEE (INCLUDING
❑
COURT TICKET - PAYMENT MADE TO MVD INSTEAD
OVERPAYMENT, DOUBLE PAYMENT OR MISAPPLIED FEES):
OF DESIGNATED COURT.
Submit copy of registration certificate and letter of explanation.
❑
DOUBLE PAYMENT
❑
TWO REGISTRATIONS AND VALIDATION STICKERS/DECALS PURCHASED
FOR ONE VEHICLE/VESSEL:
❑
OVERPAYMENT
Submit copy of vehicle/vessel registration certificate being used and the unused
❑
registration certificate and sticker/decal.
WARNING TICKET
❑
❑
INCORRECT COMPUTATION OF EXCISE TAX:
REINSTATEMENT FEE:
Submit copy of registration certificate showing fees paid and letter of explanation.
Amount Paid $
❑
VEHICLE/VESSEL TRANSFERRED FROM ONE PARTY TO ANOTHER OR
DISPOSED OF:
Indicate exact date vehicle/vessel was transferred or disposed of and method of
transfer or disposition. Submit unused registration certificate and sticker/decal.
❑
VETERANS ALLOWANCE:
Submit New Mexico Veterans Certificate of Eligibility.
❑
EXEMPTION FROM PAYMENT OF NEW MEXICO EXCISE TAX FOR A VESSEL
(BOAT).
Submit Form 10014, Affidavit of Non-Resident Military Personnel.
❑
OTHER REASON(S) FOR REFUND:
Submit supporting documents and letters of explanation (if needed).
IMPORTANT!
ALL REQUESTS FOR REFUND MUST BE ACCOMPANIED BY A COPY OF A CANCELED CHECK, MONEY ORDER OR CREDIT CARD STATEMENT
I hereby request refund of fees paid to the New Mexico Motor Vehicle Division for the reason(s) indicated above and certify
that all information given is true and correct to the best of my knowledge.
REQUESTER'S SIGNATURE
DATE
Please include all copies of payments and mail to:
Motor Vehicle Division
Driver & Vehicle Services Bureau
P.O. Box 1028
Santa Fe, New Mexico 87504-1028
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