Form Vsa 31 - Moped Certification
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1VSA 31 (12/23/2015)
MOPED CERTIFICATION
PURPOSE:
Use this form to certify compliance with moped operation requirements as defined in VA Code §46.2-100.
INSTRUCTIONS: Complete form and submit with application for title to DMV when applying to title a moped. DMV may request proof of
any information provided.
MOPED OPERATION VERIFICATION
Check to verify that:
You are titling a moped which meets the following as defined by VA Code §46.2-100:
• has 2 or 3 wheels
• has a motor size that is 50 cc's or less /1500 watts or less
• Vehicle will be operated on public highways at speeds of 35 mph or less.
NOTE: Any moped operated at speeds exceeding 35 mph OR that has a motor displacement/input exceeding 50cc/1500
watts must be titled as a motorcycle. Additionally, operating a moped in excess of 35 mph requires the operator to
comply with all applicable motorcycle requirements and is a traffic infraction punishable by a fine.
MOPED INFORMATION
YEAR
MAKE
MODEL
BODY TYPE
COLOR
VEHICLE IDENTIFICATION NUMBER (VIN)
MOTOR DISPLACEMENT/INPUT (check one)
50 cubic centimeters or less/1500 watts or less
Greater than 50 cubic centimeters/greater than 1500 watts
NOTE: A moped must be titled as a motorcycle if the motor displacement or input is greater than 50 cubic centimeters/1500 watts.
OWNER INFORMATION
OWNER FULL NAME (last, first, middile initial) OR BUSINESS NAME (if business owned)
DMV CUSTOMER NUMBER/FEIN/SSN
OWNER TELEPHONE NUMBER
(
)
CO-OWNER FULL NAME (last, first, middile initial) (print)
DMV CUSTOMER NUMBER/FEIN/SSN
CO-OWNER TELEPHONE NUMBER
(
)
OWNER'S RESIDENCE/HOME/BUSINESS ADDRESS (Apt # if applicable)
CITY
STATE
ZIP CODE
CO-OWNER'S RESIDENCE/HOME/BUSINESS ADDRESS (Apt # if applicable) CITY
STATE
ZIP CODE
Check
Moped is owned by individual(s).
If this application is for joint ownership, do you wish clear rights of ownership to be transferred to
one:
YES
NO
the surviving owner in the event of the death of either the owner or co-owner?
Moped is business owned.
IMPORTANT INFORMATION
To operate a moped you are required to:
• Carry a government issued photo identification.
• Be at least 16 years of age.
• Wear a helmet (approved by the Virginia State Police) with face shield or safety glasses (not required if moped is equipped with a
windshield).
Odometer reading, proof of insurance, safety inspection, sales and use tax, and electric fee, are NOT required to title a moped.
CERTIFICATION
The owner(s) listed above certify and affirm that all information presented in this form is true and correct, that any documents I (we) have
presented to DMV are genuine, and that the information included in all supporting documentation is true and accurate. I (we) make this
certification and affirmation under penalty of perjury and I (we) understand that knowingly making a false statement or representation on
this form is a criminal violation.
OWNER OR AUTHORIZED AGENT/REPRESENTATIVE SIGNATURE
CO-OWNER SIGNATURE
DATE (mm/dd/yyyy)
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