Form Vtr 852 – Fill Out and Use This PDF

ASE Safety Inspection and Application for

Custom Vehicle or Street Rod License Plates

VTR-852

Rev. 3/2012

Custom vehicle is defined as “a vehicle that is at least 25 years old and of a model year after 1948; or manufactured to resemble

a vehicle that is at least 25 years old and of a model year after 1948; and that has been altered from the manufacturer’s original design or has a body constructed from materials not original to the vehicle.”

Street rod is defined as “a vehicle that was manufactured before 1949; or after 1948 to resemble a vehicle manufactured before 1949; and that has been altered from the manufacturer’s original design, or has a body constructed from materials not original to the vehicle.”

IMPORTANT – VEHICLE INSPECTION REQUIRED.

SAFETY INSPECTION: The vehicle must be certified by an Automotive Service Excellence (ASE) Certified Master Automobile and Light Truck Technician as being structurally stable and safe to operate on the public highway. The ASE Technician must have current ASE certification as a Certified Master Automobile Technician; technician must inspect the vehicle, and sign the statement below.

The automotive systems and parts listed below must be inspected, as applicable, based on the year model of the replica vehicle. To obtain a Custom Vehicle or Street Rod specialty license plate, the vehicle must meet the applicable definition above, and page 2 must be completed. It is recommended that you carry a copy of this completed application in your vehicle.

VEHICLE INSPECTION – Applicable item listed below must be inspected.

Horn _________________________________	Rear Red Reflector (2) ___________________
Windshield Wipers _____________________	Wheels and Rims _______________________
Mirror ________________________________	Exhaust System ________________________
Steering ______________________________	License Plate Lamp _____________________
Seat Belts _____________________________	Tires _________________________________
Brakes – Service (Parking, beginning 1960 models)	Turn Signal Lamps (beginning 1960 models)
_____________________________	_________________________________
Beam Indicator (Beginning with 1948 models)	Head Lamps (2) (4 in 4 headlamp systems)
_________________________________	_________________________________________
Tail Lamps (2) (1 on vehicles 1959 model & earlier)	Motor, Serial or Vehicle Identification Number
________________________________	_________________________________
Stop Lamps (2) (1 on vehicles 1959 model & earlier)	__________________________

ASE TECHNICIAN STATEMENT – State law makes falsifying information a third-degree felony.

I certify that I have inspected the vehicle listed, and have determined that it is structurally stable and meets the necessary conditions to be operated safely on the public highway. The information provided is correct to the best of my knowledge at the time of inspection.

___________________________________________	___________________________________________	__________________
Technician’s Printed Name	Technician’s Signature	Inspection Date
__________________________________________	___________________________________________
ASE Certification Number	Certification Expiration Date

____________________________________________________________________	_________________
Business Name and Address	Phone

After inspection by the ASE Technician, submit this completed application to your local County Tax Assessor-Collector’s office.

UNDER STATE LAW: Texas Title must be branded “REPLICA” to obtain Custom Vehicle or Street Rod license plates. Contact your local County Tax Assessor-Collector’s office for additional information.

TO OBTAIN YOUR SPECIALTY PLATE: There is no fee for the specialty license plate but your annual registration and other applicable fees must be paid. Your plate may be personalized for an additional fee, make selection on page 2.

FOR COUNTY ASSESSOR‐COLLECTORS. Send to: Texas Department of Motor Vehicles, Vehicle Titles and Registration Division‐SPB,
Austin, TX	‐	.

ASE Safety Inspection and Application for

Custom Vehicle or Street Rod License Plates

GENERAL REQUIREMENTS – Read carefully

ASE vehicle safety inspection must be completed before this application is submitted to your county.

Texas title branded “REPLICA” and vehicle registration must be in your name. If vehicle is leased, attach a copy of the lease agreement.

If vehicle is sold, “Custom Vehicle” and “Street Rod” license plates are non-transferrable.

Upon sale or transfer, the vehicle must be re-inspected by an ASE Certified Technician in order to obtain the “Custom Vehicle” or “Street Rod” license plate.

When the specialty plate is issued, an additional fee may be collected to establish a single expiration date for both the specialty plate and the vehicle registration. If ordering by mail, contact your County Tax Assessor-Collector’s office in 2-3 weeks to verify your plate is ready for issuance. Contact your County Tax Assessor-Collector’s office if you have questions.

APPLICANT INFORMATION – Type or print only

Last Name			First Name			Middle Initial
Address		City		State	ZIP
Phone	E-mail

VEHICLE DESCRIPTION

Replica Year			Replica Make			Model
Body Style				Current TX Plate				Primary Color
Vehicle Identification Number (or Motor Number if applicable)					Title Document Number
Vehicle type					Specialty Plate type
 Passenger Car	 Truck		 Motorcycle		 Custom Vehicle		 Street Rod

STATEMENT – State law makes falsifying information a third-degree felony.

My vehicle meets the eligibility requirements listed on this form, and I am providing proof of the ASE vehicle safety inspection.

____________________________________	____________________________	__________
Applicant’s Printed Name	Signature	Date

PERSONALIZE YOUR PLATE – If you would like to personalize your specialty plate, there will be a $40 fee per year, in addition to the annual registration and other applicable fees.

Show selection(s) exactly as you want them to appear on your license plate. You may list more than one option in case the personalization you have chosen is already issued.

A selection that has already been issued, is deemed offensive, or conflicts with the regular license plate numbering system cannot be approved.

Use each selection block below to represent one character - defined as one letter, number, blank space, dash, period, Texas silhouette, or the heart symbol. Use an asterisk (* ) to indicate the Texas silhouette, and an at sign ( @ ) to indicate the heart symbol.

Passenger car and truck plates are limited to six (6) characters total. Motorcycle plates are limited to four (4) characters total.

You are not required to use all the spaces provided.

The International Symbol of Access (ISA) counts as two (2) characters. If you want the ISA and are applying for a personalized plate, the plate may consist of only three characters (or two, if for a motorcycle). Use a percent sign (%) to indicate the ISA.

1st Selection

2nd Selection

3rd Selection

Personalization fee will not be refunded once application is submitted.

INTERNATIONAL SYMBOL OF ACCESS

To display a disabled person symbol on your license plate, you must attach a signed Form VTR-214 to this application to show your eligibility for the International Symbol of Access. Contact your County Tax Assessor-Collector’s office for more information.

FOR COUNTY ASSESSOR‐COLLECTORS. Send to: Texas Department of Motor Vehicles, Vehicle Titles and Registration Division‐SPB,
Austin, TX	‐	.