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All-Terrain ( ATV ) or Utility Terrain ( UTV )
DNR Txn #
State of Wisconsin
Vehicle Registration Application
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 9400-376 (R. 6-12)
Instructions on pages 2 and 3
A. OWNER INFORMATION
Primary Owner’s Name (Last or Business Name)
(First)
(M.I.) Social Security Number or FEIN
(collected on behalf
DNR Customer Number
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. VEHICLE INFORMATION – Complete all fields
Wisconsin Registration Number
Serial Number of Body / Frame
Make
Model
Model Year
Weight
Engine Size
# of Wheels
Width
WI County Kept / Used In
Purchase Date
Previous Out-of-State Registration Number
CC
C. REGISTRATION TYPE – Select all that apply
NOTE: Only Wisconsin registrations are transferable.
1. New Registration – Public Use . . . . . . . . . $ 30.00
6. Duplicate Certificate . . . . . . . . . . . . . . . . .
5.00
2. New Registration – Private Property Use . . 15.00
7. Duplicate Decals . . . . . . . . . . . . . . . . . . . .
5.00
Check if used 95% or more of the time for agricultural purposes.
8. Municipal Registration (original / renewal)
5.00
3. Transfer . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.00
9. Commercial Certificate (original / renewal) 90.00
4. Transfer & Renewal Certificate . . . . . . . . . 35.00
10. Additional Commercial Decal (each) . . . . . 30.00
0.00
# of Extra Decal:
Total Fee $
5. Renewal (Public Use only) . . . . . . . . . . . . . 30.00
0.00
If box 10. is not checked, make sure # of Extra Decal field is "0".
D. SALES AND TAX INFORMATION – See Instructions, page 2 and 3
Trade-In
(Describe vehicle 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) . . . . . . . . . . . . . $
0.00
If Tax Exempt, enter exemption code and reason (see instructions on page 3)
Code
Reason
4. 5% State Sales Tax (Line 3 x .05) . . . . . . . . . . . . . . . . $
0.00
5. 1/2% County Tax (Line 3 x .005),
. . . . . . . $
if applicable
County,
This ATV or UTV was obtained from: (complete information below)
Football or
6. 1/2% Football Stadium Tax (Line 3 x .005),
if applicable
$
Dealer or Seller Name
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) . . . . . . . . . . . . . . $
0.00
on page 3
City
State
Zip Code
E. TOTAL REMITTANCE AND SIGNATURE
1. Registration Fee (from Section C above) . . . . . . . . . . $
0.00
Federal Employee Identification Number (FEIN)
Telephone Number
(
)
2. Tax Due (from Section D above) . . . . . . . . . . . . . . . . . $
0.00
Signature of Dealer
Date Signed
3. Late Renewal Fee – $5.00 . . . . . . . . . . . . . . . . . . . . . $
4. Validation Fee – $3.00, if applicable . . . . . . . . . . . . . . $
Leave Blank – DNR Use Only
5. Expedited Decal Service Fee – $5.00, if applicable . . . $
Received Date
Reg. ID #
6. Total Fees / Tax Due . . . . . . . . . . . . . . . . . . . . . . . . . $
0.00
Money Received
I hereby make application for registering the vehicle described on this application.
SCANNING PURPOSES
Batch Date (8 digits)
Batch Number
Signature of Owner(s)
Date Signed
Make check or money order payable to WDNR for the total amount.
Mail to: ATV / UTV Processing Center
PO Box 78701
Milwaukee WI 53278-0701
To Operate ATV or UTV:
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.