Application Clean Air Vehicle Decals Form PDF Details

With an eye towards environmental conservation and reducing traffic congestion, the State of California Department of Motor Vehicles® offers an opportunity for drivers to contribute positively through the Application for Clean Air Vehicle Decals form. This initiative, which involves a nominal fee of $8, is designed for vehicle owners desiring to obtain or replace clean air decals. These decals identify vehicles that meet stringent California exhaust standards and Federal Inherently Low-Emission Vehicle (ILEV) standards, allowing them access to High Occupancy Vehicle (HOV) lanes regardless of passenger count. The form, detailed with sections from A to F, guides applicants through providing owner information, specifying the type of decals needed (be it for original issuance, transfer, information correction, or replacements), and asserting the vehicle's compliance with emission standards through various check boxes. It's crucial for applicants to closely adhere to guidelines and complete the application correctly to avoid delays; this includes checking vehicle qualifications against the California Air Resources Board (ARB) website and ensuring the form's thorough completion. Whether for zero-emission vehicles seeking white decals or for plug-in hybrids desiring green decals, the form accommodates a diverse range of environmentally friendly vehicles. It also provides avenues for those needing replacement decals due to loss, theft, or damage, emphasizing the need for accurate and complete submission to expedite processing. Essentially, this form represents a critical step for California vehicle owners aiming to leverage clean air benefits while contributing to a more sustainable future.

QuestionAnswer
Form NameApplication Clean Air Vehicle Decals Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other nameshov sticker application, how to apply for carpool sticker, dmv clean air decal, ca hov sticker application

Form Preview Example

STATE OF CALIFORNIA

DEPARTMENT OF MOTOR VEHICLES®

A Public Service Agency

APPLICATION FOR

CLEAN AIR VEHICLE DECALS

$8 FEE REQUIRED –

MADE PAYABLE TO DMV

Mail to: DEPaRtMENt oF MotoR VEHiClES

SPECial PRoCESSiNG UNit – MS D238

P. o. BoX 932345, SaCRaMENto, Ca 94232-3450

Fee applies to all new and replacement decals. Fee does not apply to exempt agencies (except replacement decals) and owner transfer. Only the registered owner of record may apply. For vehicle qualification, check the California Air Resources Board (ARB) website at arb.ca.gov. To avoid your application from being delayed or returned unprocessed, check dmv.ca.gov/vr/decal.htm, for information on completing this form.

VEHiClE liCENSE PlatE No.

VEHiClE iDENtiFiCatioN NUMBER

YEaR

MaKE

MoDEl

SECTION A — CURRENT REGISTERED OWNER INFORMATION (name printed must match DMV records)

a Change of address (DMV 14) form is also required if the address listed below is a recent change of address, or contains a separate mailing address, currently not on DMV records.

tRUE FUll NaME (LAST, FIRST, MIDDLE) oR BUSiNESS NaME

 

DRiVER liCENSE oR iD CaRD NUMBER

 

 

 

 

 

 

 

 

 

 

Co-oWNER tRUE FUll NaME (LAST, FIRST, MIDDLE)

 

DRiVER liCENSE oR iD CaRD NUMBER

 

 

 

 

 

 

 

 

 

 

PHYSiCal RESiDENCE oR BUSiNESS aDDRESS (INCLUDE ST.,AVE., RD., CT., ETC.)

UNit No. (INDICATE APT., STE., ETC.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CitY

CoUNtY

StatE

 

 

ZiP CoDE

 

 

 

 

 

 

 

 

 

 

MailiNG aDDRESS (IF DIFFERENT FROM PHYSICAL ABOVE)

UNit No. (INDICATE APT., STE., ETC.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CitY

CoUNtY

StatE

 

 

ZiP CoDE

SECTION B — CLEAN AIR VEHICLE DECALS (must check at least one box in all three sections)

the above described vehicle meets California exhaust standards AND Federal Inherently Low-Emission Vehicle (ILEV) standards for California Clean air Vehicle Decals which permit access to High occupancy Vehicle (HoV) lanes.

NOTE: if this vehicle is a replacement Enhanced at PZEV or tZEV for a previous Enhanced at PZEV or tZEV total loss salvage or non-repairable vehicle which had Clean air Vehicle Decals, also complete Section C.

I am requesting: (Check box[es])

original decals

(Never before issued to vehicle)

transfer to new owner

information correction/update Replacement Decals/iD Card (Section C or D also required)

My vehicle’s exhaust standard is: (Check one)

White Decals

ZEV (Zero-Emission Vehicle)

UlEV (Ultra-low Emission Vehicle)

SUlEV (Super Ultra-low Emission Vehicle)

at PZEV (advanced technology Partial Zero-

Emission Vehicle)

Green Decals

Enhanced at PZEV (Enhanced advanced technology Partial Zero-Emission Vehicle) tZEV (transitional Zero-Emission Vehicle)

The motive power is: (Check box[es])

White Decals

Electric

Hydrogen fuel cell

liquefied Petroleum Gas (lPG) Compressed Natural Gas (CNG)

Green Decals

Plug-in hybrid

Conversions

My vehicle has been converted to an alternative fuel (aRB Certification letter required)

SECTION C — ENHANCED AT PZEV OR TZEV CLEAN AIR VEHICLE REPLACEMENT DECALS (total loss/salvage or non-repairable only)

Effective January 1, 2012, DMV may issue new Clean air Vehicle Decals to owners of qualifying Enhanced at PZEVs or tZEVs purchased to replace Enhanced at PZEVs or tZEVs that were originally issued Clean air Vehicle Decals prior to the statutory 40,000 Enhanced at PZEV/tZEV decal limit, and that have been subsequently declared total loss/salvage or non-repairable. applications under this section must be filed within six months of the date of the original Enhanced at PZEV’s or tZEV’s total loss.

NOTE: Regular hybrids with yellow decals Do Not qualify.

a replacement decal is needed because the vehicle was declared a:

total loss/salvage

Provide previous Enhanced AT PZEV/TZEV vehicle information below.

Non-repairable

olD VEHiClE liCENSE PlatE NUMBER

olD VEHiClE iDENtiFiCatioN NUMBER

olD YEaR

 

 

 

olD MaKE

olD MoDEl

olD DECal NUMBER (iF BEiNG REPlaCED)

 

 

 

other:

REG 1000 (REV. 3/2014) WWW

Must complete vehicle information below, even if not applying for replacement decals:

DMV USE ONLY

No. DECalS PiCKED UP CaSHiER liNE DatE StaMP

iNitialS

VEHiClE liCENSE PlatE No.

VEHiClE iDENtiFiCatioN NUMBER

YEaR

MaKE

MoDEl

SECTION D — REPLACEMENT DECALS OR ID CARD ONLY

Current Decal Number:

Replacement iD Card only

Replacement Decals (if any original decals are later located or received, the original decals are canceled and are no longer valid and must be returned to DMV.)

Replacement decals are needed because decals were:

Stolen (a copy of a police report is required.)

lost, Damaged, Destroyed, Faded (a completed/signed statement giving details in Section E is required.)

if the vehicle was involved in an accident complete the following:

Front Bumper Damaged/Replaced

Rear Bumper Damaged/Replaced

Both Front/Rear Bumper Damaged/Replaced

(a copy of a repair shop report showing repair to front [if green decals] and/or rear [both white or green decals] of vehicle must be submitted, if all three [white] or four [green] decals are not surrendered to DMV. if only one bumper was damaged/ replaced, you must surrender the remaining decal[s] from the other bumper.)

Not received from DMV (no fee). allow 30 days from issue date before applying.

Not received from prior owner of vehicle.

other:

Disposition of Decals (MUST enter number [even if zero] in BOTH A and B):

NOTE: Decals are issued in sets of three (white) or four (green) and a new decal number will be assigned. all damaged, faded, and remaining decals must be removed from vehicle and surrendered (including decals in pieces) to DMV with this application (tape to a separate sheet).

a - total number of decals lost, Damaged, Destroyed, Faded, Not Received, or Stolen:

 

.

 

B - total number of decals surrendered to DMV with this application:

 

. if less than three (white) or four (green), (1) explain

 

in Section E why the decals are unobtainable, and (2) state that there are no remaining decals on the vehicle.

SECTION E — STATEMENT OF FACTS (please explain clearly)

SECTION F — CERTIFICATION (original signature and date required)

the registered owner mailing address is valid, existing, and an accurate mailing address. i consent to receive service of process at this mailing address pursuant to Vehicle Code Section 1808.21, Code of Civil Procedure Sections 415.20, subdivision (b), 415.30, subdivision (a), and 416.90. the signature for a company or business must include the printed name of the company/business and an authorized representative’s countersignature on the signature line.

I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

PRiNtED NaME

DaYtiME tElEPHoNE NUMBER

 

(

)

SiGNatURE oF REGiStERED oWNER

DatE

 

X

 

 

 

 

 

REG 1000 (REV. 3/2014) WWW

How to Edit Application Clean Air Vehicle Decals Form Online for Free

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It will be easy to finish the form using this practical guide! Here's what you want to do:

1. Fill out the hov sticker application with a selection of necessary fields. Gather all of the important information and be sure nothing is overlooked!

How to prepare how to apply for carpool sticker portion 1

2. Your next step is to fill out these fields: I am requesting Check boxes, My vehicles exhaust standard is, The motive power is Check boxes, original decals, Never before issued to vehicle, transfer to new owner information, White Decals, White Decals, ZEV ZeroEmission Vehicle UlEV, Electric Hydrogen fuel cell, Emission Vehicle, Green Decals, Enhanced at PZEV Enhanced advanced, Green Decals, and Plugin hybrid.

Filling in segment 2 of how to apply for carpool sticker

3. The following part is mostly about olD MaKE, olD MoDEl, olD DECal NUMBER iF BEiNG REPlaCED, other, and REG REV WWW - fill out all these empty form fields.

The right way to fill out how to apply for carpool sticker portion 3

4. To move forward, the next stage will require filling out several empty form fields. Included in these are VEHiClE liCENSE PlatE No, VEHiClE iDENtiFiCatioN NUMBER, YEaR, MaKE, MoDEl, SECTION D REPLACEMENT DECALS OR, Current Decal Number, Replacement iD Card only, Replacement Decals if any original, longer valid and must be returned, Replacement decals are needed, Stolen a copy of a police report, lost Damaged Destroyed Faded a, if the vehicle was involved in an, and Front Bumper DamagedReplaced, which you'll find essential to going forward with this document.

how to apply for carpool sticker conclusion process explained (stage 4)

5. Now, the following last segment is what you'll want to finish before using the PDF. The fields in question include the next: NOTE Decals are issued in sets of, a total number of decals lost, B total number of decals, if less than three white or four, in Section E why the decals are, SECTION E STATEMENT OF FACTS, SECTION F CERTIFICATION original, and the registered owner mailing.

how to apply for carpool sticker writing process shown (portion 5)

As to the registered owner mailing and if less than three white or four, ensure that you do everything correctly in this current part. Those two are the key fields in this PDF.

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