Form VSA 14, Vehicle Registration Application Instructions

Please provide the first part of the applicant's daytime telephone number.

Please provide the second part of the applicant's daytime telephone number.

Please provide the date the applicant signed this form.

Check this box if your vehicle qualifies as having a business use according to any of the criteria in questions 1a, 1b, 1c, or 1d, meaning it does not qualify for Personal Property Tax Relief. Fill only if 'YES', 'Mileage Business Use (Yes)', 'Yes', 'Leasing Company Pays Tax Yes' is 'Yes' for any.

Please provide the area code for the co-applicant's daytime telephone number. Fill only if 'Is this vehicle held in a private trust for non-business purposes by an individual beneficiary?' is 'Yes'.

Please provide the remaining digits of the co-applicant's daytime telephone number. Fill only if 'Is this vehicle held in a private trust for non-business purposes by an individual beneficiary?' is 'Yes'.

Please provide the date the co-applicant signed the form. Fill only if 'Is this vehicle held in a private trust for non-business purposes by an individual beneficiary?' is 'Yes'.

Please provide the co-owner's DMV Customer Number, Federal Employer Identification Number (FEIN), or Social Security Number (SSN).

Please provide the co-owner's full legal name, including last name, first name, middle initial, and suffix.

Please provide the co-owner's telephone number.

Enter the city of the co-owner's residence, home, or business address.

Enter the zip code of the co-owner's residence, home, or business address.

Enter the state of the co-owner's residence, home, or business address.

Enter the co-owner's residence, home, or business street address, including apartment number if applicable.

Check this box if you are requesting a DMV record indicator for a disability that can impair communication for law enforcement purposes.

Check this box if you are requesting a Farm Plate and understand that you must also complete the Farm Vehicle Plate Certification (VSA 131).

Please provide a description for the For Hire plate, such as Taxi, Passenger For Hire, or Tow Truck. Fill only if is 'Yes'.

Check this box if the vehicle's primary fuel type is not Gas, Electric, or Diesel, and specify the type in the 'OTHER FUEL TYPE' field.

Check this box if the vehicle's primary fuel type is diesel.

Check this box if the vehicle's primary fuel type is electric.

Check this box if the vehicle's primary fuel type is gasoline.

Please specify the fuel type if it is not Gas, Diesel, or Electric. Fill only if 'Other Fuel Type' is 'Yes'.

Check this box if the vehicle is insured by a liability policy through an insurance company licensed in Virginia and will remain insured while registered or operated.

Enter the full legal name of the insurance company providing coverage for the vehicle. Fill only if 'Vehicle Is Insured' is 'Yes'.

Check this box if the vehicle is not insured, and you are remitting the applicable uninsured motor vehicle fee.

Check this box if you hold a valid intrastate operating authority certificate or permit. Fill only if 'Is this a for-hire vehicle?' is 'Yes'.

Check this box if you do not hold a valid intrastate operating authority certificate or permit. Fill only if 'Is this a for-hire vehicle?' is 'Yes'.

Please provide the lessee's full legal name, including last name, first name, middle initial, and any suffix.

Please provide the lessee's DMV customer number, Federal Employer Identification Number (FEIN), or Social Security Number (SSN).

Please enter the lessee's telephone number.

Enter the street address for the lessee's residence or business.

Enter the city corresponding to the lessee's residence or business address.

Enter the ZIP code for the lessee's residence or business address.

Enter the state corresponding to the lessee's residence or business address.

Check this box if the vehicle is not a logging vehicle.

Check this box if the vehicle is a logging vehicle.

Check this box if the vehicle is not a low speed vehicle.

Check this box if the vehicle is a low speed vehicle.

Check this box if any of the owners or lessees are currently on active military duty or service.

Check this box if none of the owners or lessees are currently on active military duty or service.

Please provide the date when the new location was entered or changed.

Check this box if you are selecting a Special Plate, and then enter the specific type of special plate.

Check this box if you are selecting the Great Seal plate.

Check this box if you are selecting the Heritage plate, also known as 'Dogwood-Cardinal'.

Check this box if you are selecting the Standard plate, also known as 'Virginia is for Lovers'.

Check this box if you are selecting the Mountain to Seashore plate.

Please enter the type of special plate you wish to request. Fill only if 'Special Plate (enter type)' is 'Yes'.

Please enter the street address or P.O. Box for the optional mailing address for registration renewals.

Please enter the city for the optional mailing address for registration renewals.

Please enter the zip code for the optional mailing address for registration renewals.

Please enter the state for the optional mailing address for registration renewals.

Please provide the email address for the owner of the vehicle.

Please provide the email address for the co-owner of the vehicle.

Please provide the full legal name of the owner, including last, first, middle initial, and suffix, or the full business name if applicable.

Please provide the owner's DMV customer number, Federal Employer Identification Number (FEIN), or Social Security Number (SSN).

Please enter the primary telephone number for the owner.

Enter the owner's full residence, home, or business street address, including any apartment, suite, or unit number.

Enter the city of the owner's residence, home, or business address.

Enter the zip code of the owner's residence, home, or business address.

Enter the state of the owner's residence, home, or business address.

Check this box if the vehicle operates as a common carrier transporting passengers for hire on a regular route. Fill only if 'Is this a for-hire vehicle?' is 'Yes'.

Check this box if the vehicle is primarily used to haul employees for hire. Fill only if 'Is this a for-hire vehicle?' is 'Yes'.

Check this box if the vehicle transports passengers for sight-seeing purposes for hire. Fill only if 'Is this a for-hire vehicle?' is 'Yes'.

Check this box if the vehicle operates as a common carrier transporting passengers for hire on an irregular route. Fill only if 'Is this a for-hire vehicle?' is 'Yes'.

Check this box if the vehicle transports passengers for hire under a contractual agreement. Fill only if 'Is this a for-hire vehicle?' is 'Yes'.

Check this box if the vehicle is used for non-emergency medical transport of passengers for hire. Fill only if 'Is this a for-hire vehicle?' is 'Yes'.

Check this box if the passenger carrier operation is conducted by a nonprofit or tax-exempt organization. Fill only if 'Is this a for-hire vehicle?' is 'Yes'.

Check this box if the vehicle operates as a taxicab, transporting passengers for hire. Fill only if 'Is this a for-hire vehicle?' is 'Yes'.

Check this box if the passenger carrier operations are considered exempt from certain regulations. Fill only if 'Is this a for-hire vehicle?' is 'Yes'.

Check this box if you are applying for a permanent plate for trailers, travel trailers, semi-trailers, trucks/tractor trucks with a GVWR or GCWR over 26,000 lbs, trucks/tractor trucks with a GVWR or GCWR between 7,501 and 26,000 lbs if used for business only, farm vehicles, taxicabs, or common carrier vehicles.

Check this box if your vehicle is for personal use and you answered NO to ALL questions a-d regarding business use. Fill only if 'NO', 'Mileage Business Use (No)', 'No', 'Leasing Company Pays Tax No' is 'Yes' for all.

Check this box if the vehicle is held in a private trust for non-business purposes by an individual beneficiary. Fill only if 'Personal Use' is 'Yes'.

Check this box if the vehicle is not held in a private trust for non-business purposes by an individual beneficiary. Fill only if 'Personal Use' is 'Yes'.

Check this box to request personalized license plates and enter your choices in the fields below.

Enter your desired character combination for your first personalized license plate choice. Fill only if 'Personalized License Plates' is 'Yes'.

Enter your desired character combination for your second personalized license plate choice. Fill only if 'Personalized License Plates' is 'Yes'.

Enter your desired character combination for your third personalized license plate choice. Fill only if 'Personalized License Plates' is 'Yes'.

Enter your desired character combination for your fourth personalized license plate choice. Fill only if 'Personalized License Plates' is 'Yes'.

Check this box if the vehicle will be used to transport property as a carrier. Fill only if 'Is this a for-hire vehicle?' is 'Yes'.

Check this box if the vehicle will be used to transport household goods as a carrier. Fill only if 'Is this a for-hire vehicle?' is 'Yes'.

Check this box if the vehicle's property carrier operations are exempt. Fill only if 'Is this a for-hire vehicle?' is 'Yes'.

Check this box if you want your vehicle registration to be valid for three years, and receive a $3 discount. This option is not available for vehicles subject to emissions testing.

Check this box if you want your vehicle registration to be valid for one year.

Check this box if you want your vehicle registration to be valid for two years, and receive a $2 discount.

Check this box if you are registering your vehicle for the first time.

Check this box if you are applying for reissued plates and/or decals for your vehicle.

Check this box if you are renewing an existing vehicle registration.

Check this box if the plates or decals to be reissued were lost.

Check this box if the plates or decals to be reissued were mutilated or destroyed.

Check this box if the plates or decals to be reissued are illegible.

Check this box if the plates or decals to be reissued were confiscated.

Check this box if you want a new plate design or character combination when reissuing plates or decals.

Provide the month and year for the reissued plates and decals. Fill only if is 'Yes'.

Provide the month and year for the reissued decals. Fill only if is 'Yes'.

Please enter the city or county that serves as the residence or business jurisdiction.

Check this box if more than 50% of the vehicle's annual mileage is used as a business expense for federal income tax purposes or if the mileage is reimbursed by an employer.

Check this box if less than or equal to 50% of the vehicle's annual mileage is used as a business expense for federal income tax purposes and the mileage is not reimbursed by an employer.

Check this box if the vehicle is leased by an individual and the leasing company pays the tax without reimbursement from the individual.

Check this box if the vehicle is leased by an individual and the leasing company does not pay the tax without reimbursement from the individual.

Check this box if the vehicle is leased by an individual and the leasing company pays the tax without reimbursement from the individual.

Check this box if the vehicle is leased by an individual and the leasing company does not pay the tax without reimbursement from the individual.

Check this box if more than 50% of the vehicle's annual mileage is used as a business expense for federal income tax purposes OR if it is reimbursed by an employer.

Check this box if 50% or less of the vehicle's annual mileage is used as a business expense for federal income tax purposes AND it is not reimbursed by an employer.

Check this box if you are requesting a small size plate for a trailer permanent registration with a gross weight of 4,000 lbs or less.

Check this box if you are requesting a regular size plate for a trailer permanent registration.

Provide the license plate number that you intend to transfer.

Check this box if you are transferring an existing license plate number to this vehicle.

Please enter the primary color of the vehicle.

Enter the name of the town where the vehicle is principally garaged.

Please provide the title number of the vehicle.

Please provide the Vehicle Identification Number (VIN) of the vehicle.

Please provide the total number of axles on the vehicle.

Please provide the current license plate number of the vehicle.

Please enter the agency code if the vehicle is state or locality-owned. Fill only if 'State or Locality-Owned: Yes' is 'Yes'.

Please enter the state code relevant to the vehicle's registration or division.

Check this box if the vehicle is not owned by the state or a locality.

Check this box if the vehicle is owned by the state or a locality.

Please enter the division code for the vehicle.

Check this box if the vehicle is a rental vehicle.

Provide a detailed description of the vehicle's use type if it falls under the 'Other' category. Fill only if 'Other' is 'Yes'.

Check this box if the vehicle's use type is not 'For Hire,' 'Rental Vehicle,' or 'Private,' and specify the use type in the provided space.

Check this box if the vehicle will be used for hire, and ensure to complete the 'For Hire Information' section.

Check this box if the vehicle is for private use, and refer to 'Reissue Plates' below under 'Plate Information' if applicable.

Enter the empty weight of the vehicle.

Enter the Gross Vehicle Weight Rating (GVWR) for a single vehicle, as provided by the manufacturer.

Enter the Gross Combined Weight Rating (GCWR) for the truck and any attached trailer.

Enter the gross weight for the truck and any attached trailer.