This form contains 52 fields organized into 16 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name	Type	Description
Application Type Selection
Original application for license plate and ID Card	Checkbox	Check this box if you are submitting an original application to obtain a new California moped license plate and ID card.
Duplicate ID Card and/or substitute license plate	Checkbox	Check this box if you are requesting a replacement (duplicate) ID card and/or a substitute license plate.
Transfer ownership	Checkbox	Check this box if you are applying to transfer ownership of the motorized bicycle (moped).
First New Owner Certification (Date and Daytime Phone)
Certification Date (New Owner 1)	Date	Enter the date the first new owner signs the certification in Section 5.
Daytime Phone Area Code (New Owner 1)	Text	Enter the area code for the first new owner’s daytime telephone number. Max length: 3 characters
Daytime Phone Number (New Owner 1)	Text	Enter the remaining digits of the first new owner’s daytime telephone number after the area code.
Form Actions
Print	Button	Click this button to print the form.
Clear Form	Button	Click this button to clear all the fields in the form.
Moped Qualification Question 1 (Two/Three-Wheel Device)
Yes	Checkbox	Check this box if the vehicle/device is a two-wheel or three-wheel device.
No	Checkbox	Check this box if the vehicle/device is not a two-wheel or three-wheel device.
Moped Qualification Question 2 (Operable Pedals / Electrical Power)
Question 2 – Yes	Checkbox	Check this box if the device has fully operative pedals for human power OR is powered solely by electrical energy.
Question 2 – No	Checkbox	Check this box if the device does not have fully operative pedals for human power AND is not powered solely by electrical energy.
Moped Qualification Question 3 (Automatic Transmission / <4 Gross Brake HP)
Yes	Checkbox	Check this box if the moped has an automatic transmission and the motor is less than 4 gross brake horsepower.
No	Checkbox	Check this box if the moped does not have an automatic transmission and/or the motor is 4 or more gross brake horsepower.
Moped Qualification Question 4 (Max Speed 30 MPH)
Yes	Checkbox	Check this box if the moped’s maximum speed is 30 miles per hour on level ground.
No	Checkbox	Check this box if the moped’s maximum speed is not 30 miles per hour on level ground.
New Registered Owner(s) Address
New Registered Owner Street Address	Text	Enter the street address (including apartment or unit number, if applicable) for the new registered owner.
New Registered Owner County	Text	Enter the county of residence for the new registered owner.
New Registered Owner City	Text	Enter the city for the new registered owner’s address.
New Registered Owner State	Text	Enter the state for the new registered owner’s address. Max length: 2 characters
New Registered Owner ZIP Code	Text	Enter the ZIP code for the new registered owner’s address.
New Registered Owner(s) Name and Driver License/ID
New Registered Owner Name	Text	Enter the new registered owner’s full legal name (last, first, middle) as it should appear on the registration.
New Owner Driver License/ID Number	Text	Enter the new registered owner’s driver license or identification card number.
AND (additional registered owner)	Checkbox	Check this box if there is an additional new registered owner to be listed along with the first owner.
OR (choose one owner name option)	Checkbox	Check this box if you are indicating the alternative owner-name option (i.e., not adding an additional owner under “AND”).
Owner Address (Street, County, City, State, ZIP)
Owner Street Address	Text	Enter the owner’s street address (including apartment or unit number if applicable). Fill only if 'Yes', 'Question 2 – Yes', 'Yes', 'Yes' is 'Yes' on all fields selection. Depends on: Yes, Question 2 – Yes, Yes, Yes
Owner County	Text	Enter the county where the owner’s address is located. Fill only if 'Yes', 'Question 2 – Yes', 'Yes', 'Yes' is 'Yes' on all fields selection. Depends on: Yes, Question 2 – Yes, Yes, Yes
Owner City	Text	Enter the city for the owner’s address. Fill only if 'Yes', 'Question 2 – Yes', 'Yes', 'Yes' is 'Yes' on all fields selection. Depends on: Yes, Question 2 – Yes, Yes, Yes
Owner State	Text	Enter the state for the owner’s address. Fill only if 'Yes', 'Question 2 – Yes', 'Yes', 'Yes' is 'Yes' on all fields selection. Max length: 2 characters Depends on: Yes, Question 2 – Yes, Yes, Yes
Owner ZIP Code	Text	Enter the ZIP code for the owner’s address. Fill only if 'Yes', 'Question 2 – Yes', 'Yes', 'Yes' is 'Yes' on all fields selection. Depends on: Yes, Question 2 – Yes, Yes, Yes
Owner Identification (Name and Driver License/ID)
Owner Full Name	Text	Enter the true full name of the owner(s) (last, first, middle) as it should appear on the application. Fill only if 'Yes', 'Question 2 – Yes', 'Yes', 'Yes' is 'Yes' on all fields selection. Depends on: Yes, Question 2 – Yes, Yes, Yes
Driver License/ID Card Number	Text	Enter the owner’s driver license number or California ID card number. Fill only if 'Yes', 'Question 2 – Yes', 'Yes', 'Yes' is 'Yes' on all fields selection. Depends on: Yes, Question 2 – Yes, Yes, Yes
AND	Checkbox	Check this box if the vehicle will be registered to two owners using “AND,” meaning both owners are listed jointly (typically requiring both owners’ signatures/approval).
OR	Checkbox	Check this box if the vehicle will be registered to two owners using “OR,” meaning either owner may act/sign on behalf of the registration.
Release of Ownership Seller Printed Name and Date
Seller Printed Name	Text	Enter the seller’s printed full name as the person releasing ownership of the vehicle.
Release of Ownership Date	Date	Enter the date the seller signs to release ownership of the vehicle.
Second New Owner Certification (Date and Daytime Phone)
Second New Owner Signature Date	Date	Enter the date the second new owner signs the certification statement.
Second New Owner Daytime Phone Area Code	Text	Enter the area code for the second new owner’s daytime telephone number. Max length: 3 characters
Second New Owner Daytime Phone Number	Text	Enter the remaining digits of the second new owner’s daytime telephone number.
Section 3 Item Status (Check One)
Lost/Stolen	Checkbox	Check this box if the plate or ID card has been lost or stolen.
Destroyed/Mutilated	Checkbox	Check this box if the plate or ID card has been destroyed or is damaged/mutilated.
Surrendered to DMV	Checkbox	Check this box if the plate or ID card was turned in (surrendered) to the DMV.
Not Received from DMV	Checkbox	Check this box if the plate or ID card was issued but you did not receive it from the DMV.
Not Received from Prior Owner	Checkbox	Check this box if you did not receive the plate or ID card from the prior owner.
Section 3 Request Type (Check One)
Substitute Plate	Checkbox	Check this box if you are requesting a substitute license plate for the motorized bicycle (moped).
Duplicate ID Card	Checkbox	Check this box if you are requesting a duplicate motorized bicycle (moped) ID card.
Vehicle Information
Vehicle Identification Number (VIN)	Text	Enter the vehicle identification number (VIN) assigned to the motorized bicycle.
Engine Number	Text	Enter the engine number as shown on the engine or vehicle documentation.
Make	Text	Enter the manufacturer (make) of the motorized bicycle.
California License Plate	Text	Enter the California license plate number currently assigned to the motorized bicycle, if any.
Model	Text	Enter the model name or number of the motorized bicycle.
Distinctive Marks or Features	Text	Describe any distinctive marks, features, or identifying characteristics of the motorized bicycle.

California DMV Form REG 230, Motorized Bicycle (Moped) Instructions/Application Instructions