Form Reg 343 - Application For Title Or Registration

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APPLICATION FOR
DMV USE ONLY
O/S DL #/STATE
TITLE OR REGISTRATION
A Public Service Agency
TECH INITIALS
VEHICLE/HULL IDENTIFICATION NUMBER
MAKE OF VEHICLE OR VESSEL BUILDER
1. OWNER INFORMATION (Please print true full name or lessor/business name)
LAST NAME OR LESSOR OR BUSINESS NAME
FIRST NAME
MIDDLE NAME
CALIFORNIA DRIVER LICENSE OR ID NUMBER
AND
OR
LAST NAME, OR LESSEE
FIRST NAME
MIDDLE NAME
CALIFORNIA DRIVER LICENSE OR ID NUMBER
AND
OR
LAST NAME, OR LESSEE
FIRST NAME
MIDDLE NAME
CALIFORNIA DRIVER LICENSE OR ID NUMBER
RESIDENCE OR BUSINESS ADDRESS (Include St., Ave., etc.)
APT./SPACE NO.
CITY
STATE
ZIP CODE
MAILING ADDRESS (If Different From Above)
APT./SPACE NO.
CITY
STATE
ZIP CODE
LESSEE ADDRESS (If Different From Above)
APT./SPACE NO.
CITY
STATE
ZIP CODE
TRAILER COACH ONLY – ADDRESS WHERE TRAILER IS LOCATED (If Different From Above)
CITY
STATE
ZIP CODE
2. TITLE HOLDER INFORMATION (Do NOT reenter owner’s name) If “NONE,” so print
NAME OF BANK/FINANCE COMPANY OR INDIVIDUAL
ELECTRONIC TITLE NUMBER
BUSINESS OR RESIDENCE ADDRESS
APT./SPACE NO.
CITY
STATE
ZIP CODE
MAILING ADDRESS (If Different From Above )
APT./SPACE NO.
CITY
STATE
ZIP CODE
3. COST AND OPERATION INFORMATION (Purchase price does not include sales tax, insurance, finance charges, or warranty.)
If new owner, enter miles at date of purchase and check here. ..................
MILES/KILOMETERS:
If no change of ownership, enter miles as of this date and check here. ......
is the
is not the
mileage exceeds the
,
.
(no tenths)
Miles
Kilo.
actual mileage
actual mileage
odometer mechanical limit
10
DATE VEHICLE ENTERED OR WAS FIRST OPERATED IN CALIFORNIA
DATE YOU WENT TO WORK IN CALIFORNIA OR BECAME A RESIDENT (WHICHEVER OCCURRED FIRST)
Mo. _____________ Day _____________ Yr. _____________
Mo. _____________ Day _____________ Yr. _____________
VEHICLE WAS PURCHASED OR ACQUIRED ON:
AND WAS (CHECK ONE BOX):
YEAR MODEL
VEHICLE WAS PURCHASED OR ACQUIRED FROM:
Mo. _________ Day _________ Yr. _________
New
Used
Dealer
Family Member
Private Party
MUST CHECK ONE BOX ONLY, AND ENTER REQUIRED INFORMATION FOR THAT ONE BOX:
I purchased this vehicle for the price of $ _______________.
I acquired this vehicle as a gift or trade. Its value when I acquired it was $ _______________.
I acquired this vehicle as a gift or trade. Its current market value is $ _____________. (Requires completed Statement of Facts [REG 256].)
A. Will this vehicle be used to carry people for hire (taxi, bus, etc.)? ...........................................................................................
Yes
No
B. When you acquired this vehicle were you on active duty in the U.S. Armed Forces? ..............................................................
Yes
No
If 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
No
If yes, a Declaration of Gross Vehicle Weight/Combined Gross Vehicle Weight Form (REG 4008) must be completed.
If yes, a Motor Carrier Permit may be required. Call (916) 657-8153 for further information.
D. Was sales tax paid to another state?
Yes
No 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 Board of
Equalization or visit
4. OWNER(S) SIGNATURE(S)
The registered owner mailing address is valid, existing, and an accurate mailing address. I consent to receive service of process at
this mailing address pursuant to VC §1808.21.
I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
OWNER’S SIGNATURE
DATE
DAYTIME TELEPHONE NUMBER
X
(
)
OWNER’S SIGNATURE
DATE
DAYTIME TELEPHONE NUMBER
X
(
)
REG 343 (REV. 8/2008) REG 343/REG 31 COMBINED WWW

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