Fillable Printable Mv Titleand Register Motor Vehicle Application

Mv Titleand Register Motor Vehicle Application

Registration Period

From Through

APPLICATION TO TITLE/REG. A VEHICLE

MINNESOTA DEPARTMENT OF PUBLIC SAFETY

Driver and Vehicle Services Division

445 Minnesota St., St. Paul, MN 55101-5185

Phone (651) 297-2126 TTY: (651 282-6555

dvs.dps.mn.gov

PLATE NUMBER YEAR

YEARYEAR VALIDATION STICKER NUMBER

WEIGHT STICKER NUMBER/MOTORCYCLE ENGINE NO.

NEW

USED

PREVIOUS PLATE NUMBER YEAR MONTH

EXPIRATION

DATE

MODEL YEAR MAKE BODY/MODEL TYPE

BODY ROOF

DOT# EMPTY WT. # AXLES

TRUCKS/TRAILERS

PURCHASER(S)

OWNER(S)

MUST

COMPLETE

Vehicle

Information

Purchaser(s)

Owner(s)

Information

FOR CENTRAL OFFICE USE ONLY

VEHICLE IDENTIFICATION NUMBER

You may disclose my information for any use in

response to requests for my individual driver or

motor vehicle record.

You may disclose my personal information for bulk

distribution for surveys, marketing or solicitations.

YEAR

LAST, FIRST, MIDDLE NAME DRIVER'S LICENSE NUMBER / DEALER NUMBER DATE OF BIRTH

DRIVER'S LICENSE NUMBER DATE OF BIRTHADDITIONAL PURCHASER(S)/OWNER(S) LAST, FIRST, MIDDLE NAME

DATE OF PURCHASE

STREET ADDRESS CITY STATE ZIP CODE

DAYTIME TELEPHONE NO. MN COUNTY/STATE VEH. IS KEPT

PURCHASER(S)

OWNER(S)

MUST

COMPLETE

IS THIS VEHICLE SUBJECT TO SECURITY AGREEMENT(S)?

YES

IF YES, COMPLETE SECTION B.

FIRST SECURED PARTY (PRINT NAME) DATE OF LOAN

For Additional Secured Parties,

Attach Completed Form PS2017

CITY ZIP CODESTATESTREET ADDRESS

SELLER(S)

MUST

COMPLETE

and SIGN

ODOMETER DISCLOSURE STATEMENT. I (WE) CERTIFY THAT THE ODOMETER

NOW READS

(NO TENTHS) MILES AND TO THE

BEST OF MY KNOWLEDGE, THE ODOMETER MILEAGE IS:

Actual mileage

In excess of odometer's mechanical limits

Not actual mileage - WARNING ODOMETER DISCREPANCY

DAMAGE DISCLOSURE STATEMENT. TO THE BEST OF

MY KNOWLEDGE, THIS VEHICLE:

Has

(CHECK ONE) SUSTAINED DAMAGE IN EXCESS

OF 80 PERCENT ACTUAL CASH VALUE.

Has Not

ASSIGNMENT: I (WE) CERTIFY THAT THIS VEHICLE IS FREE FROM ALL SECURITY INTERESTS. I (WE) WARRANT TITLE AND ASSIGN THE REGISTRATION

TAX AND VEHICLE TO THE PERSON(S)NAMED ABOVE.

SELLER'S PRINTED NAME(S)

DATE OF SALE

SELLER'S ADDRESS DEALER LICENSE #

ALL SELLER'S SIGNATURE(S)

PURCHASER(S)

OWNER(S)

MUST

COMPLETE

and SIGN

PURCHASER'S MOTOR VEHICLE SALES TAX DECLARATION

1. Full purchase price

2. Less trade-in allowance

complete item #6

3. Net purchase price

% of line 3

5. Less tax paid to another state

NET SALES TAX DUE

6. Trade-in was:

MODEL YR. MAKE PLATE #

MN DEALER LICENSE #

MN SALES TAX ACCOUNT #

INTERNAL REV. CODE # (IRC)

PRORATE ACCOUNT #

I DECLARE

THIS TAX

EXEMPTION

CODE:

(Sales tax due when registered)

NON-NEGOTIABLE REGISTRATION RECEIPT (CARD) AND CAB CARD

THIS COPY WHEN VALIDATED (STAMPED ABOVE BY A DEPUTY REGISTRAR OR THE

CENTRAL OFFICE) SERVES AS EVIDENCE THAT THIS RECEIPT HAS BEEN ASSIGNED

TO THE OWNER FOR USE ONLY ON THE VEHICLE DESCRIBED.

Change of Gross Vehicle Weight

Time of

Change

Hours

Base value or

Gross Weight

Date of

Change

Date

Change

Expires

Change of Weight and/or Class

From To

PLATE FEE

ARREARS TAX

WHEELAGE TAX

TRANSFER TAX

TITLE/TRANSFER FEE

LIEN FEE

MV SALES TAX

LATE TRANSFER PENALTY

SUB-TOTAL

STATE/DEPUTY FILING FEE

TOTAL DUE

I (WE) CERTIFY I (WE) ARE OF LEGAL AGE, HAVE PURCHASED

THIS VEHICLE SUBJECT TO LIENS SHOWN AND NO OTHER.

THIS VEHICLE IS AND WILL CONTINUE TO BE INSURED WHILE

OPERATING UPON THE PUBLIC STREETS AND HIGHWAYS. THE

VEHICLE WILL BE OPERATED IN COMPLIANCE WITH THE LAWS

THAT APPLY TO ITS CLASS OF REGISTRATION. I (WE) HAVE

RECEIVED A COPY OF THIS APPLICATION AND ALL OF MY

(OUR) DECLARATIONS ARE TRUE AND CORRECT. IF

APPLICABLE, I (WE) HAVE KNOWLEDGE OF STATE AND

FEDERAL REGULATIONS APPLICABLE TO COMMERCIAL

VEHICLE OPERATION, MINNESOTA STATUTES, CHAPTER 221,

PUBLIC SERVICE COMMISSION RULES 1 THROUGH 48 AND

CODE OF FEDERAL REGULATIONS, TITLE 49, PARTS 390

THROUGH 399, AND IF A TRANSPORTER OF HAZARDOUS

MATERIALS, CODE OF FEDERAL REGULATIONS, TITLE 49,

PARTS 171 TO 199.

PS2000-44 (05/16)

DO NOT SIGN UNTIL COMPLETE

VALIDATION AND

OFFICE USE ONLY

DVS CENTRAL OFFICE USE ONLY

-over-

DATE

ALL PURCHASERS/OWNERS MUST SIGN

COUNTY CODE

COLOR CODE

PS VEHICLE FEE

REGISTRATION TAX

WITHOUT PROPER OWNERSHIP/TRANSFER DOCUMENTS (e.g., OUT-OF-STATE

CERTIFICATE OF TITLE), NO MINNESOTA TITLE WILL BE ISSUED.

AUTO INSURANCE COMPANY POLICY NO. EXP. DATE

Print Form

View Color Codes

WERE YOU A MINNESOTA RESIDENT

AT THE TIME OF PURCHASE?

THIS VEHICLE WAS:

A VEHICLE ACQUIRED BY A MINNESOTA RESIDENT IS SUBJECT TO TAX AS SOON AS THE VEHICLE IS OPERATED ON A MINNESOTA STREET OR HIGHWAY. AN

AUTOMOBILE BROUGHT INTO MINNESOTA BY A NON-RESIDENT MUST BE REGISTERED WITHIN 60 DAYS; HOWEVER, IF THE FOREIGN STATE VEHICLE IS NOT

CURRENTLY REGISTERED, THE VEHICLE MUST BE REGISTERED IMMEDIATELY. TAX FOR THE NON-RESIDENT IS COMPUTED FROM THE APPLICATION DATE OR

60 DAYS AFTER THE VEHICLE IS BROUGHT INTO MINNESOTA, WHICHEVER IS FIRST. TAX ON A TRUCK IS DUE AND COMPUTED FROM THE APPLICATION DATE

OR THE DATE THE VEHICLE IS BROUGHT INTO MINNESOTA, WHICHEVER IS FIRST.

PS2000-44 (05/16)

PURCHASER(S)

OWNER(S)

MUST

COMPLETE

WHEN:

REGISTERING A

VEHICLE FROM

ANOTHER STATE

DATE THIS VEHICLE FIRST BROUGHT INTO MINNESOTA

USEDNEW

NOYES

UNDER LEGAL

AGE

I CERTIFY BY MY SIGNATURE I HAVE PURCHASED THE VEHICLE DESCRIBED ON THIS APPLICATION. CHECK ONE:

I am 17 years old and have completed an approved

driver training course.

I am 17 years old and a high school graduate.

I am an employed, emancipated minor and I have a

Minnesota driver's license.

When I was a resident of a foreign state, I was the duly registered owner of the automobile or

truck described on this application (COMPLETE SECTION E)

PURCHASER(S)

OWNER(S)

MUST

COMPLETE

BY LAW, THE TYPE, AND IN SOME CASES THE USE, OF YOUR VEHICLE DETERMINES WHICH REGISTRATION CLASS (PLATE) IS PROPER. THE

FOLLOWING IS A BRIEF DESCRIPTION OF THE LAW WHICH APPLIES TO THE CLASSES OF REGISTRATION. PLEASE CHECK THE BOX

CORRESPONDING TO THE PROPER CLASS FOR YOUR VEHICLE.

VEHICLE TYPE

CLASS EXPLANATION OF REGISTRATION CLASSES

AUTOMOBILE AND STATION WAGONS

PASS

All passenger automobiles and vans, station wagons, ambulances and hearses. Also all pickup trucks with a manufacturer's rated capacity of 3/4 ton or less.

Duluth Transit Bus

BDU

BUSES

Bus operated in cities of less than 70,000 population

Bus used exclusively for transporting students (must be inspected prior to registration)

Charter Bus

Intercity bus

All motorized bicycles, which do not exceed 50 cubic centimeters or 2 brake horsepower.

All motorcycles, motorbikes, minibikes and motorscooters. Engine number is required on front of form.

MOTORCYCLES AND MOPEDS

Self-propelled vehicle is a vehicle with permanently installed life support systems designed to be used for temporary living quarters while engaged in recreational or vacation

activities which uses the public streets or highways incidental to such activities and is not used as the residence of the owner or occupant. At least four of the following life support

systems must be present, two of which must be 1, 2 or 3.

RECREATIONAL

1. Cooking with liquid propane gas supply. 2. Potable water supply including sink and faucet. 3. Separate 110-125 volt electrical power supply. 4. Heating

or air conditioning separate from vehicle engine. 5. Refrigerator – electric or propane. 6. Toilet – self-contained or connected to a plumbing system.

Towed vehicle used for temporary living quarters while engaged in recreational or vacation activities which uses the public streets or highways incidental to such activities and not

used as the residence of the owner or occupant. Limited to trailers up to 102” in width and 45’ in length.

All semi-trailers (Permanent plate)

TRAILERS

Trailer with a gross weight of more than 3,000 pounds (except those registered in the B (utility), recreational, farm or semi trailer classes) or an equipment dolly used to transport the

owner’s construction machinery, equipment, implements and other objects used on a construction project, but not to be incorporated in or to become a part of a completed project.

Farm trailer with a gross weight in excess of 10,000 pounds drawn by a passenger automobile or farm truck. Used exclusively for transporting agricultural products from farm to

farm and to and from the usual market. May be registered on an annual or quarterly basis.

Trailer with a maximum gross weight of 3,000 pounds (except those registered in the recreational or farm classes). Permanent registration.

Park trailer (used for temporary living quarters) exceeds 8-1/2' in width but is no larger than 400 sq. Ft. (note: park trailers not used on the highways during the calendar year shall

be taxed as manufactured homes).

(Not Plated)

Manufactured homes any trailer or semi-trailer which is designed, constructed and equipped for use as a human dwelling place, living abode or living quarters. The manufactured

home is 320 sq. ft. Or more when erected on site.

(Not Plated)

Gross weight trucks used exclusively by the owner, to transport farm products or personal property from farm to market or to transport property and supplies to the owner’s farm or

occasionally used to transport unprocessed and raw farm products not produced by the owner of the truck from the place of production to market when such transportation

constitutes the first haul of such products, or used to transport raw and unfinished forest products harvested by the truck owner from the place of production to an assembly yard or

rail head when such transportation constitutes the first haul thereof, or used to transport milk and/or cream from a farm to an assembly point or place of final manufacture and/or

from an assembly point for final processing or manufacture providing the truck is a single unit truck and solely constructed for such use. Farm trucks may be registered on an annual

or quarterly basis.

TRUCKS

Trucks used only in the commercial zone.

For CZ registration, enter LCC or ICC permit number:

All gross weight trucks except those registered in the farm or commercial zone class.

NOTE: TRAILERS AND TRUCKS REGISTERED ON A GROSS WEIGHT BASIS MUST BE REGISTERED AT A MINIMUM OF 1.25 TIMES THE EMPTY WEIGHT.

† FOR TRUCKS REGISTERED AT 78,000 OR HIGHER, MUST DECLARE THE NUMBER OF AXLES ON THE FRONT OF THIS APPLICATION NEXT TO THE OWNER’S SIGNATURE.

CHECK HERE IF VEHICLE IS A TRUCK-TRACTOR

†

Classic Car as defined by law (M.S. 168.10), and owned and operated solely as a collector’s item and not for general transportation purposes.

UNIQUE CLASSES

FOR CLASSIC, COLLECTOR, STREET ROD & PIONEER, PLEASE INDICATE DESIRED NUMBER OF PLATES:

One Plate Two Plates

Collector Vehicle is a vehicle which is at least 20 model years old and manufactured after 1935 and owned and operated solely as a collector’s item and not for general

transportation purposes. To register a vehicle in the collector class, the owner of the vehicle must have one or more vehicles with regular license plates.

COL

REGULAR LICENSE PLATE NUMBER OF THE OTHER VEHICLE OWNED OR LEASED BY YOU:

Street Rod is a motorized vehicle manufactured prior to 1949 or designed and manufactured to resemble such vehicle and owned and operated solely as a street rod and

not for general transportation purposes. To register a vehicle as a street rod, the owner of the vehicle must have one or more vehicles with regular license plates.

Pioneer Vehicle Is a vehicle manufactured prior to 1936 which is owned and operated solely as a collector’s item and not for general transportation purposes.

Tax Exempt all vehicles required to display tax-exempt license plate(s) must have the name of the state department or political subdivision, non-public high school

operating a driver education program or licensed commercial driving school, plainly displayed on both sides of the vehicle; except those exempted by M.S. 168.012. For

more information regarding the marking or exemption requirements please call DVS at (651) 205-4082.

FOR ADDITIONAL INFORMATION, CONTACT A DEPUTY REGISTRAR OR THE DEPARTMENT OF PUBLIC SAFETY

-over-

NON-COMMERCIAL Y CLASS - Non-commercial Y class (plate) is for one-ton pick-up trucks registered at 10,000, 12,000 or 15,000 used exclusively for personal use.

PS2000-44 (05/16)

SELLER(S) MUST COMPLETE:

PURCHASER(S) / OWNER(S) MUST COMPLETE: AND

PURCHASER(S) / OWNER(S) MUST ALSO COMPLETE:

WHEN REGISTERING A VEHICLE FROM ANOTHER STATE

WHEN UNDER LEGAL AGE

DATA PRIVACY / RESTRICTED INFORMATION

ALL DATA COLLECTED ON A MOTOR VEHICLE APPLICATION, WITH THE EXCEPTION OF YOUR HOME TELEPHONE NUMBER, ARE REQUIRED

BY LAW. THESE DATA ARE USED TO IDENTIFY YOUR MOTOR VEHICLE. FAILURE TO PROVIDE REQUIRED DATA MAY RESULT IN DENIAL OF

THE TRANSFER OF OWNERSHIP, REGISTRATION OF THIS VEHICLE AND OTHER REQUESTED ACTION.

EXCEPT FOR CERTAIN USES PERMITTED BY FEDERAL AND STATE LAWS, PERSONAL INFORMATION CONTAINED IN YOUR APPLICATION MAY

NOT BE DISCLOSED TO ANYONE WITHOUT YOUR EXPRESS CONSENT.

BEFORE COMPLETING

PLEASE READ CAREFULLY

A B D G

, ,

A C D

VEHICLE COLOR CODES:

BLACK

BLUE

BROWN

GOLD

GRAY

GREEN

IVORY

LAVENDER

MAROON

ORANGE

PINK

RED

SILVER

TAN

WHITE

YELLOW

OWNERSHIP INFORMATION

WHEN THIS VEHICLE IS TRANSFERRED, ALL OWNERS MUST SIGN THE ASSIGNMENT, WHETHER THE VEHICLE IS OWNED AS JOINT TENANTS (OR,

AND/OR) OR AS TENANTS IN COMMON (AND-NO CONJUNCTION). THE DEATH OF A JOINT TENANT REQUIRES PROOF OF DEATH, APPLICATION FOR

TITLE BY THE SURVIVING JOINT TENANT AND APPROPRIATE FEES. THE DEATH OF A SOLE OWNER OR OF A TENANT IN COMMON REQUIRES AN

APPLICATION FOR TITLE BY THE SURVIVOR, APPROPRIATE FEES AND EITHER THE PROBATE COURT DOCUMENT OR A SURVIVING SPOUSE/NO

PROBATE FORM (PS2071) ALONG WITH PROOF OF DEATH. IF THIS VEHICLE IS LEASED FOR MORE THAN 180 DAYS, A LESSEE DESIGNATION FORM

(PS2019) MUST BE ATTACHED.

DISCLOSURE STATEMENTS MUST BE SIGNED BY ALL SELLERS

WARNING

FEDERAL AND STATE LAWS REQUIRE THAT YOU STATE THE MILEAGE IN CONNECTION WITH THE TRANSFER OF OWNERSHIP. MINNESOTA LAW

REQUIRES THAT YOU MAKE DISCLOSURES ABOUT DAMAGE TO THE VEHICLE. FAILURE TO COMPLETE OR PROVIDING A FALSE STATEMENT MAY

RESULT IN FINES AND/OR IMPRISONMENT; SOME EXEMPTIONS MAY APPLY.

AN ODOMETER STATEMENT IS NOT REQUIRED FOR:

1. A VEHICLE HAVING A GROSS VEHICLE WEIGHT RATING OF MORE THAN 16,000 POUNDS;

2. A VEHICLE THAT IS NOT SELF-PROPELLED; OR

3. A VEHICLE THAT IS 10 YEARS OLD OR OLDER.

MUST BE SIGNED BY ALL PURCHASERS (OWNERS)

MOTOR VEHICLE SALES TAX EXEMPTIONS AND CODES (M.S. 297B.01 Subd. 14)

EXEMPTIONS CAN BE USED ONLY AS LISTED. NO CHANGES MAY BE MADE!

WHEN THIS VEHICLE IS TRANSFERRED, ALL OWNERS MUST SIGN THE ASSIGNMENT, WHETHER THE VEHICLE IS OWNED AS JOINT TENANTS (OR, AND/OR) OR

AS TENANTS IN COMMON (AND-NO CONJUNCTION). THE DEATH OF A JOINT TENANT REQUIRES PROOF OF DEATH, APPLICATION FOR TITLE BY THE

SURVIVING JOINT TENANT AND APPROPRIATE FEES. THE DEATH OF A SOLE OWNER OR OF A TENANT IN COMMON REQUIRES AN APPLICATION FOR TITLE BY

THE SURVIVOR, APPROPRIATE FEES AND EITHER THE PROBATE COURT DOCUMENT OR A SURVIVING SPOUSE/NO PROBATE FORM (PS2071) ALONG WITH

PROOF OF DEATH. IF THIS VEHICLE IS LEASED FOR MORE THAN 180 DAYS, A LESSEE DESIGNATION FORM (PS2019) MUST BE ATTACHED.

When a vehicle is acquired for nominal or no monetary consideration, tax must be based on the average value of similar vehicles.

CODE EXEMPTION

Vehicle was a transfer between husband and wife in a divorce proceeding,

indicate “divorce."

Vehicle was selected by the surviving spouse, or acquired by inheritance or

bequest.

Vehicle is held for resale by a lending institution or insurance company. Indicate

Minn. sales and use tax account number.

Vehicle was transferred from joint ownership to ownership by one or more of the

same joint owners without monetary consideration or vehicle transfer is

exempted by an internal revenue code. Indicate IRC code number.

Purchaser was a non-resident when vehicle was purchased and subsequently

became a resident of Minnesota more than 60 days after the date the vehicle

was titled in another state.

CODE EXEMPTION

A disabled veteran purchased vehicle with funds provided by the veteran’s

administration. Must submit letter from the V.A.

Purchaser is an interstate carrier holding a common carrier direct pay certificate.

Prorate vehicle only. Indicate prorate account number.

Vehicle is held for resale or lease by a licensed Minnesota dealer or lessor who

has a Minnesota dealer’s license number. Indicate dealer license number.

Purchase of a motor vehicle by a private, non-profit, or public educational

institution for use as an instructional aid in automotive training programs

operated by the institution.

10.

Vehicle is a municipal fire apparatus, marked patrol car or municipal ambulance,

of which the general appearance is unmistakable, or the purchase of an

ambulance by a licensed ambulance service.

THE ONLY TRADE-IN ACCEPTABLE FOR REDUCTION OF PURCHASE PRICE IS ANOTHER REGISTERED OR PREVIOUSLY REGISTERED MOTOR VEHICLE.

FARM EQUIPMENT, FURNITURE, ANIMALS, ETC., CANNOT BE LISTED AS A TRADE-IN.

ANY PERSON WHO SHALL COMPLETE OR SUBMIT A FALSE OR FRAUDULENT MOTOR VEHICLE PURCHASER’S CERTIFICATE WITH INTENT TO DEFEAT OR EVADE

SALES TAX SHALL BE GUILTY OF A MISDEMEANOR AND FOR EACH OFFENSE SHALL BE FINED NOT MORE THAN $500 OR BE IMPRISONED IN THE COUNTY JAIL

FOR NOT MORE THAN ONE YEAR OR BOTH.

TO DETERMINE ANY TAX AMOUNT AND/OR FEES OR TO OBTAIN ASSISTANCE IN COMPLETING THIS APPLICATION, CONTACT A DEPUTY REGISTRAR OR THE

DEPARTMENT OF PUBLIC SAFETY, DIVISION OF DRIVER AND VEHICLE SERVICES.