Form 9400-210 - Snowmobile Registration Application
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Snowmobile Registration Application
State of Wisconsin
DNR Txn #
To Instructions
Department of Natural Resources
dnr.wi.gov
Page 1 of 3
Please PRINT using BLACK INK
1-888-936-7463
DNR Call Center:
Form 9400-210 (R. 6-12)
Instructions on pages 2 and 3
A. OWNER
Primary Owner’s Name (Last or Business Name)
Social Security Number or FEIN
DNR Customer Number
(First)
(M.I.)
(collected on behalf
of Dept. of Revenue
for tax purposes)
Mailing Address
Date of Birth (MM-DD-YYYY)
U.S. Citizen?
Daytime Telephone
Check if
address
(
)
YES
NO
change
City
State
Zip Code
County
E-mail Address
Check to withhold my personal information from disclosure on lists of 10 or more individuals that DNR may provide to other persons (sec. 23.45, Wis. Stats.)
Additional Owner’s Name (Last, First, Middle Initial or Business)
Check if more than 2 additional owners and attach list of names.
AND
AND
1.
2.
OR
OR
B. SNOWMOBILE – Complete all fields
Wisconsin Registration Number
Serial Number of Body / Frame
Make
Model
Model Year
CC Disp
Horsepower
Width
WI County Kept / Used In
Purchase Date
Previous Out-of-State Registration Number
C. REGISTRATION TYPE –
NOTE: Only Wisconsin registrations are transferable.
Select all that apply
1. New Registration – Public Use . . . . . . . . $ 30.00
7. Duplicate Decals . . . . . . . . . . . . . . . . . . .
5.00
2. New Registration – Private Property Use
0.00
8. Antique (Manufacture year 1966 or older) 20.00
3. Transfer . . . . . . . . . . . . . . . . . . . . . . . . .
5.00
9. Municipal Registration (original / renewal)
5.00
4. Transfer & Renewal Certificate . . . . . . . . 35.00
10. Commercial Certificate (original / renewal)
90.00
5. Renewal only (Public Use) . . . . . . . . . . . 30.00
11. Additional Commercial plate (each) . . . . . 30.00
0.00
# of Extra Plates:
Total Fee $
6. Duplicate Certificate . . . . . . . . . . . . . . . .
5.00
0.00
If box 11. is not checked, make sure # of Extra Plates field is "0".
D. SALES AND TAX INFORMATION –
See Instructions, page 2
Trade-In
(Describe snowmobile or property traded, Year, Make & Serial # of Body)
1. Purchase Price (include accessories) . . . . . . . . . . $
2. Allowance for Trade-In . . . . . . . . . . . . . . . . . . . . . $
3. Taxable Receipts (Line 1 less Line 2) . . . . . . . . . . $
If Tax Exempt, enter exemption code and reason (see instructions on page 3)
0.00
Code
Reason
4. 5% State Sales Tax (Line 3 x .05) . . . . . . . . . . . . . $
0.00
5. 1/2% County Tax (Line 3 x .005), if applicable . . . . $
This snowmobile was obtained from: (complete information below)
County,
Football or
Dealer or Seller Name
6. 1/2% Football Stadium Tax (Line 3 x .005),
$
if applicable
Baseball
Stadium
7. 1/10% Baseball Stadium Tax (Line 3 x .001),
$
if applicable
Tax Due?
Mailing Address
See instr.
8. Total Tax Due (Add lines 4, 5, 6, 7) . . . . . . . . . . . $
on page 3
0.00
City
State
Zip Code
E. TOTAL REMITTANCE AND SIGNATURE
Federal Employee Identification Number (FEIN)
Telephone Number
1. Registration Fee (from Section C above) . . . . . . . . $
(
)
0.00
2. Tax Due (from Section D above) . . . . . . . . . . . . . . $
Signature of Dealer
Date Signed
0.00
3. Validation Fee – $3.00, if applicable . . . . . . . . . . . $
Leave Blank – DNR Use Only
4. Expedited Decal Service Fee – $5.00, if applicable
$
Received Date
Reg. ID #
5. Total Fees / Tax Due . . . . . . . . . . . . . . . . . . . . . . $
0.00
Money Received
I hereby make application for registering the snowmobile described on this application.
SCANNING PURPOSES
Batch Date (8 digits)
Batch Number
Signature of Owner(s)
Date Signed
WDNR
Make check or money order payable to
for the total amount.
Mail to: Snowmobile Processing Center
PO Box 78701
Milwaukee WI 53278-0701
To Operate Snowmobile:
Operator is required to carry a copy of this form validated by a DNR office or an
authorized agent; or, if purchased from a Wisconsin dealer, operator must carry a
copy. See requirements on the bottom of page 2.
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