International Registration Plan Supplemental Application Form – Fill Out and Use This PDF

	AlAbAmA DepArtment of revenue
	motor vehicle Division
	international registration plan
MV IRP-C (9/14)	supplemental Application
	Instructions on reverse side

DEPARTMENT USE ONLY

EFFECTIVE

DATE __________________

INITIALS _________________

Renewal Mo/License Yr.

Account Number

Fleet Number

Email Address

Registrant Name

Contact Person

Business Address

City

WEIGHT GROUP

Telephone Number

(            )

State

Zip

Fax Number

(            )

1

Unit

Number

Model

Year

Vehicle

Make

Vehicle

Color

Vehicle Identification

Vehicle

Type

Axles/ Seats

Fuel Type

Unladen

Weight

2

Unit

Number

Model

Year

Vehicle

Make

Vehicle

Color

Vehicle Identification

Vehicle

Type

Axles/ Seats

Fuel Type

Unladen

Weight

1

Unit

Number

Vehicle Identification Number

Combined

Gross Weight

Reason Removed

Date

Removed

Tag

Number

2

Unit

Number

Vehicle Identification Number

Combined

Gross Weight

Reason Removed

Date

Removed

Tag

Number

REGISTRANTINFORMATION

RENEWAL MONTH/LICENSE YEAR: the renewal month and current li- cense year. (Ex. Aug/2014)

ACCOUNT NUMBER: the account number assigned by the Motor Vehi- cle Division.

FLEET NUMBER: the two-digit fleet number. (Ex. 01)

REGISTRANT NAME: the legal name of the person, firm, or corporation in which the account is registered.

BUSINESS ADDRESS: the street or highway and building number, or rural route box number (no P O Boxes) along with the city, state, and zip code of the location where the records are maintained.

CONTACT PERSON: name, telephone number, fax number, and e-mail address of the person who is authorized to conduct business on behalf of the registrant.

WEIGHTGROUP

WEIGHT GROUP: Indicate the appropriate combined gross weight in the jurisdiction for which apportioned registration is sought. If you are using this section to increase the vehicle(s) registered weight, you can find the maximum weights for all jurisdictions on the IRP website at www.irponline.org.

ADDITIONS

UNIT NUMBER: vehicle unit number assigned by the applicant. Be sure to use a different unit number for each vehicle.

MODEL YEAR: the model year of the motor vehicle.

VEHICLE MAKE: the trade name of the vehicle. (Ex. MACK, FRHT, KW, etc.) A list of Standard Vehicle abbreviations is found in the Alabama Motor Carrier Services Manual on the website at http://revenue.ala- bama.gov/motorvehicle/forms.cfm.

VEHICLE COLOR: the color of the vehicle. (Ex. WHI, BLK, BRO, etc.) A list of vehicle color codes may be found in the Alabama Motor Carrier Services Manual on the website at http://revenue.alabama.gov/ motorvehicle/forms.cfm.

VEHICLE IDENTIFICATION NUMBER (VIN): complete serial number reflected on the title or application for title.

VEHICLE TYPE: TR – tractor, TK – truck, TT – truck tractor, BS – bus.

AXLE/SEATS: the number of axles on the motor vehicle, including steer- ing axle. Do not include trailer axles. Enter the number of seats for buses.

FUEL TYPE: the type of fuel used by the motor vehicle. (Ex. D – diesel, G – gasoline, P – propane, CNG – compressed natural gas, LNG – liq- uefied natural gas, etc.)

UNLADEN WEIGHT: The empty weight of the motor vehicle fully equipped for service.

COMBINED GROSS WEIGHT: The weight of the motor vehicle including the heaviest load to be carried on trailing equipment used in combination with the motor vehicle.

PURCHASE PRICE: The price of the motor vehicle including trade-ins, but excluding sales or use tax and finance charges. Do not show cents. When payments are "taken-over," the purchase price is equity paid plus the amount of principal still owed.

PURCHASE/LEASE DATE: the month, day, and year the motor vehicle was purchased/leased.

NAME OF OWNER/LESSOR: the name of the owner or operator as it appears on the Certificate of Title or Alabama Application for Certificate of Title. For vehicles under a lease-purchase plan, show the name of the owner or operator as shown on the Certificate of Title or Alabama Application for Certificate of Title. The name of the lease-purchaser may be shown in addition to the name of the owner.

TITLE NUMBER: the number shown on the Certificate of Title or Ala- bama Application for Certificate of Title. If the vehicle is titled in another state, enter the abbreviation of the state in which the vehicle is titled. The ownership of each vehicle must be supported by a copy of a Certifi- cate of Title or Alabama Application for Certificate of Title.

US DOT NUMBER & TAXPAYER IDENTIFICATION NUMBER: the num- bers assigned to the Motor Carrier Responsible for Safety (MCRS) of the vehicle by the FMCSA.

IS THE MCRS EXPECTED TO CHANGE DURING THE REGISTRA- TION PERIOD?: circle yes or no

TAG NUMBER: the most recent license plate number assigned to the motor vehicle.

DELETIONS

UNIT NUMBER: vehicle unit number from which tag is being transferred.

VEHICLE IDENTIFICATION NUMBER: complete serial number as listed on the Certificate of Title or Alabama Application for Certificate of Title.

COMBINED GROSS WEIGHT: The weight of the motor vehicle including the heaviest load to be carried on trailing equipment used in combination with the motor vehicle.

REASON REMOVED: reason the motor vehicle was removed from service (i.e. sold, junked, lease broken, etc.).

DATE REMOVED: the month, day, and year the motor vehicle was re- moved from service.

TAG NUMBER: license plate number being transferred or deleted.

SIGNATURE/TITLE/DATE: original signature of the owner, partner, cor- porate officer or person holding power of attorney for the company.