Application For Conversion Of Off-Peak Car (Opc) / Weekend Car (Wec) / Normal Car printable pdf download

10 Sin Ming Drive Singapore 575701

R10

Tel: 1800-CALL LTA (1800-2255582) Fax: (65) 65535329

APPLICATION FOR CONVERSION OF

*R_10*

OFF-PEAK CAR (OPC) / WEEKEND CAR (WEC) / NORMAL CAR

You may take about 5 minutes to complete this form. You will need the following information to fill in the form:

• • • • Vehicle Registration Number

• • • • Road Tax Expiry Date

• • • • Particulars of Registered Vehicle Owner

• • • • Particulars of Submitter

• • • • Company Stamp (if applicable)

• • • • Particulars of Director / Partner / Sole-Proprietor / Manager if the vehicle is registered in the name of a Company / Business / Limited Liability

Partnership / Limited Partnership / Club / Association / Organisation

IMPORTANT : Please read the terms & conditions overleaf carefully before completing the form.

Vehicle Registration No.:

Road Tax Expiry Date:

(day)

(month)

(year)

SECTION A – PARTICULARS OF AND DECLARATION BY REGISTERED VEHICLE OWNER

* NRIC (Singaporeans, Singapore PRs and Malaysians) /

Passport (Foreigners other than Malaysians) /

ACRA Certificate No. / UEN No.

Name of Registered Vehicle Owner (as in NRIC / Passport / ACRA Certificate): ___________________________________________________

Conversion (please

)

: (1)

Normal Car to OPC under the revised OPC scheme

(2)

WEC to OPC under the revised OPC scheme

(3)

OPC to OPC under the revised OPC scheme

(4)

OPC / OPC under the revised OPC scheme to Normal Car

(5)

WEC to Normal Car

(a) *I / We shall seal the vehicle number plates for the OPC at a LTA-authorised vehicle inspection centre within 3 calendar days from the conversion date

(applicable for conversion to OPC).

(b) *I / We understand that once the vehicle is successfully converted as per options (2), (3) or (5) above, the vehicle cannot be converted back to its original

scheme. As for option (4) above, the vehicle can only be converted back to an OPC under the revised OPC scheme.

(c) *I / We understand that once the vehicle is successfully converted as per options (2) and (5) above, the entitlement to the 5 free supplementary licences a year

upon road tax renewal shall no longer apply.

(d) *I / We understand that once the vehicle is successfully converted to an OPC under the revised OPC scheme, the 6-monthly OPC cash rebate (if applicable) will

be granted to the registered vehicle owner as at the payout date.

(e) *I / We consent to the collection, use or disclosure of *my / our personal data to a 3

party as per paragraph 9 overleaf of this application form.

)

(f)

*I / We authorise the submitter named in Section B below to submit this application and transact on *my / our behalf (where applicable

_____________________________

_____________________________________________________________

____________________

Contact Number

Signature of Registered Vehicle Owner & Company Stamp (if applicable)

Date