Louisiana Vehicle Application Form PDF Details

The Louisiana Vehicle Application form, provided by the Department of Public Safety and Corrections' Office of Motor Vehicles, is a crucial document for vehicle owners within the state. Designed to streamline various vehicle-related procedures, this form encapsulates a broad spectrum of applications, including but not limited to, the transfer of ownership, application for new plates, declaration of vehicle type (such as salvage, reconstructed, or farm use), and changes to vehicle information. It requires the meticulous completion of all mandatory fields to avoid rejection, emphasizing the importance of accurate and comprehensive information concerning the vehicle's make, model, year, VIN (Vehicle Identification Number), and mileage, as well as the owner's details such as name, driver’s license number or EIN, and principal residence. Additionally, it addresses legal and financial aspects like lienholder information, application for duplicate titles, and various fees associated with vehicle registration. Emphasizing compliance with state laws, the form also mandates the disclosure of insurance details, reinforcing the importance of liability coverage. Failure to submit this form within specified timelines could potentially lead to penalties, underscoring the critical nature of timely adherence to procedure as set forth by the Louisiana Department of Public Safety and Corrections.

QuestionAnswer
Form NameLouisiana Vehicle Application Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesla title application, vehicle application, dpsmv 1799, dpsmv 1799 louisiana

Form Preview Example

 

 

 

 

 

 

 

 

 

 

 

 

 

Louisiana Department of Public Safety and Corrections

 

 

 

 

 

 

 

 

 

TO AVOID REJECTION:

 

 

 

 

 

 

 

 

Office of Motor Vehicles

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Complete all required information

 

 

P.O. Box 64886, Baton Rouge, LA 70896-4886

TRANSFER CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ELECTRONIC FUND

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date Prepared

Type of Plate

 

 

 

 

 

 

VEHICLE APPLICATION

 

 

 

 

DEALER CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VIN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Make

 

 

 

 

License No.

 

 

 

 

 

 

 

Exp. Date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Body

 

 

Color

 

 

 

Year

 

 

 

 

Mileage

 

 

 

Model/Weight

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of Owner

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Driver's License or EIN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of Joint Owner (if applicable)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Driver's License or EIN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Owner's Principal Residence Address (or Business Location if Vehicle is Used for Commercial Purposes)

 

 

 

 

 

 

Are you

residing within the corporate limits of municipality?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YES

 

 

 

 

NO

 

 

 

 

 

 

 

City

 

 

 

 

 

 

 

 

 

Parish

 

State/Zip

 

 

 

 

 

 

Are you residing within a special tax district or ward?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YES

 

 

 

 

NO

 

If yes, what ward or district?

 

 

 

Lessee

 

Mail To

 

Domicile

Renter

 

 

 

 

If lessee, domicile, or renter is indicated, renewal notice

should be mailed to (check one):

 

 

 

Domicile Code

 

 

 

 

 

 

 

 

 

 

.

Owner

 

 

Lessee, renter, or domicile address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Driver's License or EIN of Lessee or Renter

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Street

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Trade VIN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

 

 

 

 

 

 

 

 

Parish

 

State/Zip

 

 

 

 

 

 

 

 

Trade License No.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VEHICLE IS SUBJECT TO SECURITY AGREEMENT AS FOLLOWS:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ELECTRONIC LIEN

First Lienholder's Name

 

 

 

 

 

 

 

 

 

 

 

 

 

Second Lienholder's Name

 

 

 

 

 

 

 

 

 

 

 

 

 

TRANSFER CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Street

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Street

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City/State/Zip

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City/State/Zip

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

New

Date Acquired

 

Tax Date

 

Previous Title No.

 

State

Cost of Vehicle

 

 

 

 

Less Trade

 

 

 

 

 

 

 

 

 

 

 

Used

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Title Fee

 

 

 

 

Lic Pen Credit

 

 

 

 

 

Handling Fee

 

 

 

Rebate

 

 

 

 

Tax Value

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mortgage Fee

 

Tax

 

 

 

 

 

Tow Fee

 

 

 

 

 

DUPLICATE TITLE AFFIDAVIT (Must be signed by owner and notarized.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The certificate of title issued to me was

 

 

 

 

 

 

 

 

 

License Fee

 

 

 

*Tax Penalty

 

 

 

 

 

Miscellaneous Fee

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

. lost

 

 

 

mutilated

 

 

never received

 

Lic Transfer Fee

 

*Interest

 

 

 

 

 

Total Fees

 

 

 

 

 

I make application for a duplicate copy of said certificate and agree to hold the

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

License Credit

 

Vendor's Comp

 

 

 

 

 

Total Taxes

 

 

 

 

 

Commissioner harmless if the previous title is obtained by another person.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I give the Commissioner permission to mail the title to the address on this

 

License Penalty

 

Tax Credit

 

 

 

 

 

Grand Total

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

application.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BE SURE TO SIGN AND DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I do swear or affirm that the information contained in this document is true and

 

 

 

 

 

 

 

Owner(s)'s Signature(s) for Duplicate Title

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

correct to the best of my knowledge.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I have and will maintain, during this registration period, vehicle liability insurance

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Witness

 

 

 

 

 

 

 

Witness

 

(security) required by LRS Title 32:861-865. Failure to maintain as agreed will

Sworn and subscribed before me this ________ day of ____________, _______

 

be a violation of law which may result in criminal prosecution and/or suspension

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

of registration privileges.

 

 

 

 

 

 

 

 

 

 

 

 

Notary Public Signature, Printed Name

 

 

 

 

 

 

ID Number

 

If the vehicle being registered is defined as a commercial motor vehicle by the

 

 

 

AFFIDAVIT OF NON-POSSESSION OF TITLE BY LIENHOLDER.

 

Federal Motor Carrier Safety Regulations and/or Federal Hazardous Material

 

 

 

 

Regulations, by signature below registrant declares knowledge of those federal

 

 

 

 

Must be signed by lienholder and notarized.

 

regulations.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I hereby swear or affirm that title of above described vehicle showing lien in our

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

favor was

never received

 

received and surrendered to the owner.

 

 

 

 

 

Applicant's Signature

 

 

 

 

 

 

 

Date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Co-Applicant's Signature

 

 

 

 

 

 

 

Date

 

 

 

 

 

 

 

 

 

Lienholder's Signature

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PROOF OF LIABILITY INSURANCE MUST BE FURNISHED AS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PROVIDED FOR BY LAW BEFORE THIS FILE CAN BE PROCESSED.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Witness

 

 

 

 

 

 

 

Witness

 

 

 

TO AVOID PENALTY AND INTEREST:

 

 

 

 

 

Sworn and subscribed before me this ________ day of ____________, _______

 

File must be submitted within 40 days from the date of purchase. For

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

manufactured houses (mobile homes), file must be submitted by the 20th of the

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

month following the month of delivery.

 

 

 

 

 

 

 

 

 

 

 

Notary Public Signature, Printed Name

 

 

 

 

 

 

ID Number

 

*Tax Penalty: 5% of sales tax due for 30 days or fraction thereof (not to

 

 

RECEIVED/REJECTION DATE(S)

 

 

 

 

 

 

 

 

 

.

 

 

 

 

exceed 25%).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*Interest: 1.25% of sales tax due for 30 days or fraction thereof

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

.

 

 

 

(no maximum).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOTICE:

If a title, license plate, or validation sticker is not received within thirty (30) days after submitting application and fees for such, contact your nearest Office of Motor Vehicles. Departmental policy provides for the issuance of a free replacement within sixty (60) days from the date of issuance. Failure to notify this office timely could result in additional fees being charged.

A.

CONVERSION

 

 

Old License Plate Number _____________________

New License Plate Number _____________________

 

Use _____________________

Use _____________________

 

Weight _____________________

Weight _____________________

B.TRANSFER OF PLATE

License plate ___________________ has been removed from a _______________________________________________________

YEAR MAKE VIN

and transferred to the vehicle described on the first page of this form. License plate returned is ______________________________

C. LOST, STOLEN, OR REPLACEMENT

PLATE

STICKER

License Plate Number ________________

D.TITLE CORRECTION

Error: _____________________________________________________________________________________________________

__________________________________________________________________________________________________________

Correct To: ________________________________________________________________________________________________

__________________________________________________________________________________________________________

E.FARM USE STATEMENT

I do declare that I am a bona fide farmer and am in the business of farming; that the vehicle described on the first page of this form is used primarily, but not exclusively, in hauling farm produce raised on my farm, from such farm to market and return therefrom; hauling merchandise to my farm and that this vehicle will not be used to haul another person's farm produce or other products for a fee or compensation. Said farm is located at:

________________________________________________________________________________________________________________

RFDBoxCityParishZip

________________________________________________________________________________________________________________

Owner's Signature

F.OUT OF STATE DECLARATION

I,

declare that the

 

 

 

(Printed name of owner)

 

 

MAKE

MODEL

VIN

was domiciled in Louisiana on

 

 

.

 

 

G.DISCLOSURE OF SALVAGE / RECONSTRUCTED / WATER DAMAGED / HAIL-DAMAGED

I,

swear under penalties of perjury that:

(Printed name of owner)

the title covering the vehicle,

MAKEMODEL

Louisiana R.S. 32:706.1, has been branded:

VIN

Salvaged Vehicle

,in accordance with

Reconstructed Vehicle

In accordance with Louisiana R.S. 32:789, the undersigned confirm that the above referenced vehicle has sustained water damage to the following extent:

In accordance with Louisiana R.S. 32:781, the undersigned confirm that the above referenced vehicle has sustained water damage

to the following components: Power Train

Computer

Electrical System

In accordance with Louisiana R.S. 32:702(13), the undersigned confirm that the above referenced vehicle has sustained only cosmetic damage caused by hail, equivalent to seventy-five percent or more of its market value as a result of costs or repairs to items such as windshield, windows, and rear glass; exterior paint and paint materials; and body damage such as dents.

Hail-Damaged

Signed by

under penalties of perjury this day of

(Signature of vehicle owner)

, 20

False statements are punishable by fine, imprisonment or both under R.S. 32:730.

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dpsmv 1799 form conclusion process shown (stage 1)

2. Once this part is done, you're ready put in the required specifics in License Fee, Tax Penalty, Miscellaneous Fee, Lic Transfer Fee, Interest, License Credit, Vendors Comp, License Penalty, Tax Credit, Total Fees, Total Taxes, Grand Total, BE SURE TO SIGN AND DATE, I do swear or affirm that the, and DUPLICATE TITLE AFFIDAVIT Must be so that you can move on to the third stage.

Filling out section 2 in dpsmv 1799 form

3. This next step will be focused on NOTICE If a title license plate or, CONVERSION Old License Plate, New License Plate Number Use, C D, TRANSFER OF PLATE License plate, YEAR MAKE VIN, and transferred to the vehicle, LOST STOLEN OR REPLACEMENT TITLE, PLATE, STICKER, License Plate Number, Error, Correct To, FARM USE STATEMENT, and E I do declare that I am a bona - type in these blank fields.

Filling out segment 3 of dpsmv 1799 form

4. To move ahead, your next step involves filling out a handful of fields. Examples include E I do declare that I am a bona, Owners Signature F OUT OF STATE, declare that the, Printed name of owner, was domiciled in Louisiana on, swear under penalties of perjury, MAKE, MODEL, VIN, the title covering the vehicle, Printed name of owner, MAKE Louisiana RS has been, Reconstructed Vehicle, Salvaged Vehicle, and MODEL, which you'll find integral to moving forward with this particular process.

Filling in section 4 of dpsmv 1799 form

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dpsmv 1799 form conclusion process explained (part 5)

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