Dmv Form Vsa 14 – Fill Out and Use This PDF

DMV Form VSA 14 is a form that requires you to provide detailed information about your insurance carrier, including the policy number and certificate of coverage.

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Dmv Form Vsa 14 PDF Details

DMV Form VSA 14 is a form that allows you to apply for a driver's license in the state of Virginia. The form can be downloaded from the DMV website, or you can pick one up at your local DMV office. It's important to note that you must have a social security number in order to complete the application process. If you don't have a social security number, visit the Social Security Administration website for more information. In addition, you'll need to provide proof of your identity and residency in Virginia. Be sure to gather all of the required documentation before filling out the application form. If you have any questions, contact the DMV directly.

You will discover information regarding the type of form you wish to prepare in the table. It will show you how much time it will need to fill out dmv form vsa 14, exactly what parts you will need to fill in and some further specific details.

Question	Answer
Form Name	Dmv Form Vsa 14
Form Length	2 pages
Fillable?	Yes
Fillable fields	141
Avg. time to fill out	28 min 46 sec
Other names	va dmv dsa 14, vsa 14 instructions, va vehicle form dmv, vsa dmv

12

Form Preview Example

VSA 14 (02/25/2021)

VEHICLE REGISTRATION APPLICATION

Purpose: Use this form to apply for registration of your vehicle.

Note: You must obtain a Virginia vehicle safety inspection sticker and pay any required local vehicle registration fees to your city or county. For the City of Virginia Beach only, DMV collects local vehicle registration fees.

Instructions: Refer to the Registration Information Sheet (VSA 14I) for general registration information. All owners must sign the Certification section. Mail completed form with a check or money order (made payable to DMV) to the Special Registration Work Center at the above address, or present to any DMV Customer Service Center (CSC) or DMV Select.

Note: A $10.00 late fee will be charged if registration is renewed after the expiration date.

REGISTRATION INFORMATION

Registration Type: (check one)

Original

Reissue (Plates & Decals)

Renewal

Transfer License Plate Number:

Check if applicable:

ENTER PLATE NUM

For Hire (complete "For Hire Information" section)

Rental Vehicle

Private

Other:

See Reissue Plates below under

SPECIFY

Plate Information.

Registration Period: (check one)

One Year

Two Years ($2 discount applies)

Three Years ($3 discount applies)

(not available for vehicles subject to emissions testing)

OWNER INFORMATION

OWNER'S FULL LEGAL NAME (last, first, mi, suffix) OR BUSINESS NAME (if business owned)

TELEPHONE NUMBER

DMV CUSTOMER NUMBER / FEIN / SSN

CO-OWNER'S FULL LEGAL NAME (last, first, mi, suffix)

TELEPHONE NUMBER

DMV CUSTOMER NUMBER / FEIN / SSN

NOTE: Owners (and Lessees if applicable) MUST provide their residence/home/business address where requested, this address

RESIDENCE/BUSINESS JURISDICTION

can not be a P.O. Box. You must complete form ISD-01 if you would like your address(es) updated.

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

OWNER EMAIL ADDRESS

CO-OWNER EMAIL ADDRESS

LOCATION WHERE VEHICLE IS PRINCIPALLY GARAGED

IF NEW LOCATION ENTER DATE CHANGED

Are any of the owners/lessees on active

CITY

COUNTY

TOWN OF

military duty or service?

YES

NO

IF YOU WOULD LIKE YOUR REGISTRATION RENEWALS SENT TO AN ADDRESS OTHER THAN YOUR RESIDENCE/BUSINESS ADDRESS, ENTER IT BELOW.

REGISTRATION MAILING ADDRESS - OPTIONAL

CITY

STATE

ZIP CODE

LEASE INFORMATION (if applicable)

LESSEE'S FULL LEGAL NAME (last, first, mi, suffix)		TELEPHONE NUMBER	DMV CUSTOMER NUMBER / FEIN / SSN

LESSEE'S RESIDENCE/BUSINESS ADDRESS	CITY			STATE	ZIP CODE

VEHICLE INFORMATION

YEAR

MAKE

MODEL

BODY TYPE

VEHICLE IDENTIFICATION NUMBER (VIN)

TITLE NUMBER

CURRENT PLATE NUMBER

NUMBER OF AXLES

EMPTY WEIGHT

GVWR WEIGHT SINGLE VEHICLE (manufacturer)

GROSS WEIGHT (truck & attached trailer)

GCWR COMBINED WEIGHT (truck & attached trailer)

FUEL

GAS

DIESEL

OTHER FUEL TYPE

VEHICLE

PRIMARY

IS THIS A LOW

YES

IS THIS A

YES

LOGGING

TYPE

ELECTRIC

OTHER

COLOR

SPEED VEHICLE?

NO

NO

VEHICLE?

IS VEHICLE STATE OR

YES - enter agency code

AGENCY CODE

DIVISION CODE

STATE

LOCALITY-OWNED?

NO

PERSONAL PROPERTY TAX RELIEF ELIGIBILITY

1. Answer the questions below to determine if your vehicle qualifies for car tax relief.

YES

NO

a. Is more than 50% of the vehicle's annual mileage used as a business expense for federal income tax purposes OR reimbursed by an employer?

b. Is more than 50% of the depreciation associated with the vehicle deducted as a business expense for federal income tax purposes? c. Is the cost of the vehicle expensed pursuant to Section 179 of the Internal Revenue Service Code?

d. If the vehicle is leased by an individual, does the leasing company pay the tax without reimbursement from the individual?

2.	If you answered YES to ANY of the above questions, check Business Use. Your vehicle is considered by State law to have a business use and does
	NOT qualify for Personal Property Tax Relief.	BUSINESS USE
3.	If you answered NO to ALL of the above questions, check Personal Use and answer the question below.
	PERSONAL USE -- Is this vehicle held in a private trust for non-business purposes by an individual beneficiary?		YES NO

YES NO

VSA 14 (02/25/2021) -- Page 2

FOR HIRE INFORMATION

Check to indicate how the vehicle being registered will be used. (check all that apply)

PASSENGER CARRIER OPERATIONS

PROPERTY CARRIER OPERATIONS

Common Carrier - Regular Route

Employee Hauler

Sight-seeing Carrier

Property Carrier *

Common Carrier - Irregular Route

Contract Passenger Carrier

Non-Emergency Medical Transport

Household Goods Carrier *

Nonprofit/Tax-Exempt

Taxicab

Exempt Operations - Passengers *

Exempt Operations - Property *

*

You must also complete the For-Hire Vehicles Registration Request (MCS115)

Do you hold a valid intrastate operating authority certificate/permit?

If no, and you are a passenger carrier you must also complete the For-Hire Vehicles Registration Request (MCS115).

PLATE INFORMATION

Note: Virginia offers more than 200 unique plates for our citizens. Please visit

www.dmvNow.com for a listing of special plates available.

Not all plates are available for all vehicle types and some special plates require a certification form. Review our website for additional information.

New Plates: (check one)

Standard - (Virginia is for Lovers)

Mountain to Seashore

Heritage (Dogwood-Cardinal)

Great Seal

Special Plate (enter type)

Permanent Plate -

may be issued to trailers, travel trailers, or semi-trailers; trucks/tractor trucks with a GVWR or GCWR of more than 26,000 lbs.; trucks/tractor trucks with

GVWR or GCWR of 7,501 to 26,000 lbs. if used for business only; farm vehicles registered pursuant to § 46.2-698; taxicabs or other motor vehicles

performing a taxicab service; common carrier vehicles

Farm Plate - You must ALSO complete the Farm Vehicle Plate Certification (VSA 131).

Trailer Permanent - one-time fee (check one):

Regular size plate

Small size plate (trailer gross weight must be 4,000 lbs or less)

For Hire Plate (enter description):

(examples: Taxi, Passenger For Hire, Tow Truck, etc.)

Plates

Plates and Decals (enter month/year)

Decals (enter month/year)

Reissue Plates/Decals(check one)

Lost

Mutilated/Destroyed

Illegible

Confiscated

I want a new plate design/character combination

PERSONALIZED LICENSE PLATES: To request personalized license plates, check this box and enter your choices below.

1st

3rd

2nd

4th

Communication Impairment Indicator Option - For law enforcement purposes, I request a DMV record indicator for a disability that can impair communication.

INSURANCE CERTIFICATION

I/We certify that (check one):

This vehicle is insured by a liability policy issued through an insurance company licensed to do business in Virginia and it will remain insured while registered, whether or not it is operated. Penalties are severe for violation of this requirement. Be advised that the amount of liability coverage required is higher for vehicles that are operated for hire.

NAME OF INSURANCE COMPANY

This vehicle is not insured; therefore, I am remitting the applicable uninsured motor vehicle fee. (This fee provides no insurance coverage.) A vehicle must be insured with liability coverage when it is registered, and it must remain insured while registered, whether or not it is operated, or the uninsured motor vehicle fee must be paid. Penalties are severe for violation of this requirement.

NOTICE

PRIVACY NOTICE: The information, including Social Security Number, is requested in accordance with Virginia Code §§46.2-623 and 46.2-629. Any person who refuses to supply the required information will be denied a certificate of title and/or registration. By signing this form, you authorize DMV’s exchange of title and registration records with business, law enforcement, or government entities and you authorize DMV’s exchange of title and registration records in accordance with Va. Code §§46.2-208 through 46.2-214 and 18 U.S.C. 2721.

POWER OF ATTORNEY FOR NON-RESIDENT(S) AND CORPORATION(S) NOT DOMICILED IN VIRGINIA: Pursuant to the provisions of Virginia Code §46.2-601, I/we

appoint the Commissioner of the Department of Motor Vehicles of the Commonwealth of Virginia, to be my/our true and legal agent upon whom all legal processes against me/us may be served in any legal proceeding arising from the operation and/or use of any motor vehicle registered in my/our name(s) in the Commonwealth of Virginia. I/we agree that any lawful process or notice to me/us which is served on the Commissioner shall have the same legal effect as if served on me/us within the Commonwealth of Virginia.

CERTIFICATION

I/We 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.

If the vehicle to be registered has a gross weight of 26,001 pounds or more, I/we further certify and affirm my/our knowledge of all applicable state and federal motor carrier safety and hazardous materials laws and regulations.

If I/we have requested Amateur Radio Operator Call Letter license plates, I/we certify and affirm that I/we will return those plates to DMV for another type of license plate within 90 days if my/our amateur radio license becomes invalid for any reason.

An authorized representative must sign for a corporation or company.

APPLICANT/AUTHORIZED CORPORATION/COMPANY REPRESENTATIVE SIGNATURE	DAYTIME TELEPHONE NUMBER		DATE (mm/dd/yyyy)
	(	)

CO-APPLICANT SIGNATURE	DAYTIME TELEPHONE NUMBER		DATE (mm/dd/yyyy)
	(	)

DMV USE ONLY

CHECK IF NO FEE □			CSC TRANSACTION FEE (TOTAL RENEWALS X $5)
CHECK IF NO FEE □
LICENSE PLATE NUMBER	DECAL MONTH	DECAL YEAR	ADDITIONAL FEE

CSR STAMP

REGISTRATION FEE

REISSUE FEE

UMV FEE

FEE TOTAL

How to Edit Dmv Form Vsa 14 Online for Free

This PDF editor was built to be as simple as it can be. If you comply with the following steps, the process of preparing the va 14 file is going to be simple and easy.

Step 1: Press the orange "Get Form Now" button on the following webpage.

Step 2: The document editing page is currently available. Include information or modify present content.

For each segment, prepare the details demanded by the program.

vsa14 spaces to consider

Enter the requested details in CO, OWNER, 'S RESIDENCE, HOME, BUSINESS CITY, STATE, ZIP CODE, OWNER EMAIL ADDRESS, CO, OWNER EMAIL ADDRESS, LOCATION WHERE VEHICLE IS, IF NEW LOCATION ENTER DATE CHANGED, CITY, COUNTY, TOWN OF, military duty or service, YES, IF YOU WOULD LIKE YOUR, REGISTRATION MAILING ADDRESS -, CITY, STATE, ZIP CODE, LESSEE, 'S FULL LEGAL NAME (last, TELEPHONE NUMBER, D, MV CUSTOMER NUMBER / FEIN / S, SN LEASE INFORMATION (if applicable), LESSEE, 'S RESIDENCE, BUSINESS ADDRESS, CITY, STATE, ZIP CODE, YEAR, MAKE, VEHICLE INFORMATION, MODEL, BODY TYPE, VEHICLE IDENTIFICATION NUMBER V, IN TITLE NUMBER, CURRENT PLATE NUMBER, NUMBER OF AXLES, EMPTY WEIGHT, G, VW, R WEIGHT SINGLE VEHICLE, GROSS WEIGHT (truck & attached, and GC, WR COMBINED WEIGHT (truck & part.

vsa14 CO-OWNER

You can be expected to note the details to let the program fill in the area EMPTY WEIGHT, G, VW, R WEIGHT SINGLE VEHICLE, GROSS WEIGHT (truck & attached, GC, WR COMBINED WEIGHT (truck &, FUEL TYPE, GAS, ELECTRIC, DIESEL, OTHER, OTHER FUEL TYPE, VEHICLE COLOR, PRIMARY, IS THIS A LOW SPEED VEHICLE, YES IS THIS A LOGGING NO VEHICLE, YES NO, IS VEHICLE STATE OR LOCALITY, OWNED YES - enter agency code NO, AGENCY CODE, DIVISION CODE, STATE, PERSONAL PROPERTY TAX RELIEF, YES NO, NOT qualify for Personal Property, BUSINESS USE, PERSONAL USE -- Is this vehicle, and YES.

step 3 to finishing vsa14

The space New Plates: (check one), Standard - (Virginia is for Lovers), Mountain to Seashore, Heritage Dogwood, Cardinal Great Seal, Special Plate (enter type), Permanent Plate -, may be issued to trailers, Farm Plate - You must ALSO, Trailer Permanent - one, time fee, Regular size plate, Small size plate (trailer gross, For Hire Plate (enter description):, (examples: Taxi, Reissue Plates, Decals, check one), Plates, Plates and Decals (enter, Decals (enter month, year Lost, Mutilated, Destroyed Illegible, Confiscated, I want a new plate, PERSONALIZED LICENSE PLATES: To, 1, st 3, rd 2, nd 4, th and Communication Impairment Indicator is going to be where one can indicate both parties, ' rights and responsibilities.

New Plates: (check one), Standard - (Virginia is for Lovers), Mountain to Seashore, Heritage (Dogwood-Cardinal), Great Seal, Special Plate (enter type), Permanent Plate -, may be issued to trailers, Farm Plate - You must ALSO, Trailer Permanent - one-time fee, Regular size plate, Small size plate (trailer gross, For Hire Plate (enter description):, (examples: Taxi, Reissue Plates/Decals(check one), Plates, Plates and Decals (enter, Decals (enter month/year), Lost, Mutilated/Destroyed, Illegible, Confiscated, I want a new plate, PERSONALIZED LICENSE PLATES: To, 1st, 3rd, 2nd, 4th, and Communication Impairment Indicator in vsa14

Finish by reviewing all of these areas and submitting the required particulars: I, We certify that (check one):, This vehicle is insured by a, NAME OF INSURANCE COMPANY, This vehicle is not insured;, NOTICE, PRIVACY NOTICE: The information, POWER OF ATTORNEY FOR, CERTIFICATION, and I, We certify and affirm that all.

Completing vsa14 part 5

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