Form Les 022A – Fill Out and Use This PDF

The Les 022A form, dated 07/01/2018, serves as a crucial document for individuals aiming to request an examination of a rebuilt salvage vehicle. This form is essential for ensuring that the vehicle in question meets the necessary standards for safety and functionality, following its reconstruction. For those looking to navigate the process of having their rebuilt salvage vehicle examined, clicking the button below will guide you through the necessary steps to fill out and submit the Les 022A form effectively.

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Form Les 022A PDF Details

Navigating the complexities of vehicle registration, especially for those that have been rebuilt after being designated as salvage, involves understanding and correctly submitting specific forms to the Department of Motor Vehicles (DMV). The LES 022A form plays a crucial role in this process, serving as a formal request for the examination of a rebuilt salvage vehicle. This form, updated on July 1, 2018, outlines the necessary steps and documentation required to proceed with an examination, providing a clear pathway for vehicle owners to achieve legal roadworthiness. Individuals or companies seeking this examination must complete and submit the LES 022A, alongside applicable documents such as the Virginia Salvage Title or an out-of-state equivalent, and meet the specified fees. Furthermore, the form mandates detailed information regarding the requester, the vehicle, the repairs completed, and requires a certification of the authenticity and accuracy of the submitted information under penalty of perjury. Additionally, the LES 022A specifies the prerequisites for the examination, including passing a Virginia State safety inspection and presenting evidence of such with the application. This form embodies the intersection of legal diligence, safety standards, and regulatory compliance, ensuring that rebuilt vehicles meet the necessary criteria before being allowed back on public roads.

Question	Answer
Form Name	Form Les 022A
Form Length	1 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	15 sec
Other names	les 22a, les 022a dmv, les022a, les 022a 2018

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		REQUEST FOR EXAMINATION	LES 022A (07/01/2018)
		REQUEST FOR EXAMINATION
		OF REBUILT SALVAGE VEHICLE
Purpose:	Use this form to request an examination of a rebuilt salvage vehicle.
Instructions:	Complete this form and return it to DMV at the above address along with the required documents and fees. If you have questions about
	requesting an examination contact DMVDirect at (804) 497-7100 or visit us on the web at www.dmvnow.com.
NOTE: You must be licensed as a rebuilder to have two or more salvage vehicles examined within a 12 month consecutive period.

		DOCUMENTS & FEES REQUIRED FOR PROCESSING
Virginia Salvage Title In Your Name -		Completed LES 022A - VA Salvage Title - Title Fee $15 - Exam Fee $125

Virginia Salvage Title Assigned To You -		Completed LES 022A - VA Salvage Title - Salvage Certificate Application (VSA56) - Bill of Sale -
Virginia Salvage Title Assigned To You -		4.15% Sales Tax or minimum $75 whichever is greater - Title Fee $15 - Exam Fee $125

Out-of-State Salvage Title In Your Name (or)

Completed LES 022A - Out-of-State Title - Salvage Certificate Application (VSA56) - Bill of Sale (if title is not in your name) - 4.15% Sales Tax or minimum $75 whichever is greater - Proof of Sales Tax paid in another state

Out-of-State Salvage Title Assigned To You -

(if paid) - Title Fee $15 - Exam Fee $125

REQUESTERS INFORMATION

INDIVIDUAL/COMPANY NAME (print - last, first, middle, suffix)					DRIVER LICENSE NUMBER/FEIN

STREET ADDRESS (no P.O. Box)		CITY		STATE	ZIP CODE

VEHICLE LOCATION ADDRESS (if different from above)		CITY		STATE	ZIP CODE

BEST TIME TO CONTACT YOU	TELEPHONE NUMBER		CELL PHONE NUMBER	EMAIL ADDRESS

If you were not involved in the actual repairing of the vehicle, enter the Individual/Company name and address who repaired the vehicle.

INDIVIDUAL/COMPANY NAME (print - last, first, middle, suffix)

STREET ADDRESS (no P.O. Box)			CITY		STATE	ZIP CODE

REBUILDER LICENSE NUMBER	LICENSE EXPIRATION DATE	NMVTIS ID NUMBER		INDEPENDENT DEALER NUMBER			LICENSE EXPIRATION DATE

VEHICLE INFORMATION

YEAR	MAKE	MODEL	BODY TYPE	VEHICLE IDENTIFICATION NUMBER (VIN)	# AXLES	COLOR

PARTS REPAIRED/REPLACED (must be completed)

REPAIRED REPLACED

Front Bumper

Right Fender

Left Rear Quarter Panel

Engine

Grill

Left Front Door

Right Rear Quarter Panel

Transmission

Hood

Right Front Door

Trunk

Frame/Unibody

Radiator Support

Left Rear Door

Rear Bumper

Air Bags

Left Fender

Right Rear Door

Roof

Dash

Water Damaged

SPECIFY REPAIRS

or Not Listed:

If you have replaced a Pickup Cab or Frame, vehicle is reconstructed and may need to be assigned a new Vehicle Identification Number.

REQUIREMENTS FOR VEHICLE EXAMINATION

Vehicle MUST be rebuilt prior to submitting this request - painting is optional. If vehicle does not pass the examination or you fail to keep your scheduled

appointment you must request a new examination, submit a new LES 022A and pay the necessary fees.

Vehicle must have passed a VA State safety inspection after completion of the repairs and prior to the exam. VA Code § 46.2-1605.

You may obtain a trip permit to move your vehicle to and from a VA state safety inspection facility using the below link. www.dmv.virginia.gov/vehicles/temp_permit.asp.

Initial here that the state safety inspection is complete.

Other items required for the exam - Original part receipts - Photo of the vehicle prior to repairs - Old component parts containing a VIN (if available).

CERTIFICATION (all owners must sign)

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.

OWNER/AUTHORIZED AGENT NAME (print)

OWNER/AUTHORIZED AGENT SIGNATURE

DATE (mm/dd/yyyy)

OWNER/AUTHORIZED AGENT NAME (print)

OWNER/AUTHORIZED AGENT SIGNATURE

DATE (mm/dd/yyyy)

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This form will need you to enter specific information; in order to guarantee consistency, you should heed the suggestions listed below:

1. Firstly, once filling in the les 022a form, beging with the area that includes the next blank fields:

2. Just after finishing the last section, go to the subsequent stage and enter the essential details in these fields - Front Bumper, Grill, Hood, Radiator Support, Left Fender, SPECIFY REPAIRS, Water Damaged or Not Listed, Right Fender, Left Front Door, Right Front Door, Left Rear Door, Right Rear Door, Left Rear Quarter Panel, Right Rear Quarter Panel, and Trunk.

As to Hood and Right Front Door, make sure that you double-check them here. Those two are the most important ones in the page.

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Form Les 022A – Fill Out and Use This PDF

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