Form Reg 343 - Application For Appointment As Notary Public
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1
2APPLICATION FOR TITLE OR REGISTRATION
A Public Service Agency
For accuracy, please print legibly. complete both sides.
SECTION 1 — VEHICLE INFORMATION
VEHICLE IDENTIFICATION NUMBER
VEHICLE MAKE
YEAR MODEL
FUEL TYPE
CALIFORNIA LICENSE NUMBER
MODEL OR SERIES
BODY TYPE MODEL
MOTORCYCLE ENGINE NUMBER
TYPE OF VEHICLE (CHECK ONE BOX)
FOR TRAILER COACHES ONLY
Coach
Auto
Commercial
Motorcycle
Off Highway
Trailer
LENGTH
IN.
WIDTH
IN.
(includes truck or pickup)
Will this vehicle be used for the transportation of persons for hire, compensation, or profit (e.g. limousine, taxi, bus, etc.)? ....
Yes
No
Is this a commercial vehicle that operates at 10,001 lbs. or more (or is a pickup exceeding 8,001 lbs. unladen and/or
11,499 lbs. Gross Vehicle Weight Rating (GVWR)? ...................................................................................................................
Yes
No
If yes, a Declaration of Gross Vehicle Weight/Combined Gross Vehicle Weight (REG 4008) form must be completed.
IMPORTANT:
If yes, a Motor Carrier Permit may be required. Refer to www. dmv.ca.gov for more information.
FOR COMMERCIAL VEHICLES ONLY
Actual
Number of axles:
Unladen weight:
Estimated (Vehicles over 10,001 lbs. only)
SECTION 2 — OWNER INFORMATION each owner must sign on reverse side.
Once registered, upon transfer of ownership, co-owners joined by “AND” require the signature of each owner; co-owners joined by “OR” require
the signature of only one owner.
TRUE FULL NAME OF OWNER (LAST, FIRST MIDDLE, SUFFIX), BUSINESS NAME, OR LESSOR
DRIVER LICENSE/ID CARD NUMBER
STATE
TRUE FULL NAME OF CO-OWNER OR LESSEE (LAST, FIRST, MIDDLE, SUFFIX)
DRIVER LICENSE/ID CARD NUMBER
STATE
AND
OR
TRUE FULL NAME OF CO-OWNER OR LESSEE (LAST, FIRST, MIDDLE, SUFFIX)
DRIVER LICENSE/ID CARD NUMBER
STATE
AND
OR
PHYSICAL RESIDENCE OR BUSINESS ADDRESS (INCLUDE ST., AVE., CT., ETC.)
APT./SPACE/STE. NO. CITY
STATE
ZIP CODE
COUNTY OF RESIDENCE OR COUNTY WHERE VEHICLE/VESSEL IS PRINCIPALLY GARAGED
EQUIPMENT NUMBER (OPTIONAL)
MAILING ADDRESS (IF DIFFERENT FROM PHYSICAL ADDRESS ABOVE)
APT./SPACE/STE. NO. CITY
STATE
ZIP CODE
LESSEE ADDRESS (IF DIFFERENT FROM ABOVE)
APT./SPACE/STE. NO. CITY
STATE
ZIP CODE
TRAILER COACH ONLY - ADDRESS WHERE LOCATED (IF DIFFERENT FROM PHYSICAL ABOVE)
CITY
STATE
ZIP CODE
SECTION 3 — LEGAL OWNER (LIEN HOLDER/TITLE HOLDER) if none, must write “none” .
Attention ELT Legal Owners: The ELT name and address and ELT number MUST be entered exactly as shown on the ELT listing.
TRUE FULL NAME OF BANK/FINANCE COMPANY OR INDIVIDUAL (DO NOT RE-ENTER NAME OF NEW REGISTERED OWNER(S) ABOVE)
ELECTRONIC LIENHOLDER ID NO.
ELT
PHYSICAL RESIDENCE OR BUSINESS ADDRESS (INCLUDE ST., AVE., CT., ETC.)
APT./SPACE/STE. NO. CITY
STATE
ZIP CODE
MAILING ADDRESS (IF DIFFERENT FROM PHYSICAL ADDRESS ABOVE)
APT./SPACE/STE. NO. CITY
STATE
ZIP CODE
SECTION 4 — ODOMETER INFORMATION
The odometer
(no tenths)
If kilometers
upon date of purchase in California was
10
reading:
miles,
check this box:
,
as of this date is (if no change in ownership)
ths
and to the best of my knowledge reflects the ACTUAL mileage unless one of the following statements is checked.
WARNING — ODOMETER DISCREPANCY
Odometer reading is NOT the actual mileage
Mileage EXCEEDS the odometer mechanical limits
Explain odometer discrepancy:
.
REG 343 (REV. 2/2012) WWW
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