Vehicle Application Form Louisiana PDF Details

Are you interested in purchasing a vehicle from your local dealership and are looking for an efficient way to apply? The Louisiana Office of Motor Vehicles offers a convenient online system with the Vehicle Application Form that allows individuals to complete their paperwork without having to step foot inside of a DMV office. This easy solution saves applicants time and stress as they can fill out the form, submit it electronically and have confirmation within minutes. By using this simple approach, users can quickly get started on their journey towards driving away in their new ride. Keep reading to learn more about how this process works!

QuestionAnswer
Form NameVehicle Application Form Louisiana
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesla title application form, louisiana title app, la dmv title application, louisiana vehicle title app pdf

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

ELECTRONIC FUND

 

 

TRANSFER CODE

 

 

Date Prepared

 

Type of Plate

 

 

 

 

VEHICLE APPLICATION

 

 

DEALER CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VIN

 

 

 

 

 

 

 

Make

 

License No.

 

Exp. Date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Body

Color

 

Year

 

Mileage

 

 

Model/Weight

 

If vehicle is a manufactured home, is it used as a residence?

 

 

 

 

 

 

 

 

 

 

 

YES

NO

 

 

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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Federal Motor Carrier Safety Regulations and/or Federal Hazardous Material

 

 

 

 

AFFIDAVIT OF NON-POSSESSION OF TITLE BY LIENHOLDER.

 

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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Pay attention while completing this document. Make certain every single field is filled in correctly.

1. You will want to fill out the vehicle application form louisiana correctly, thus be careful while filling out the sections containing all these blank fields:

louisiana vehicle title app pdf conclusion process clarified (portion 1)

2. The subsequent step is usually to fill in these particular blank fields: Street, CityStateZip, New Used Title Fee, Date Acquired, Tax Date, Previous Title No, State, Cost of Vehicle, Lic Pen Credit, Handling Fee, Rebate, Street, CityStateZip, Less Trade, and Tax Value.

Step number 2 of filling out louisiana vehicle title app pdf

Those who use this document often make mistakes when filling in State in this section. Be certain to go over whatever you enter right here.

3. In this stage, review I do swear or affirm that the, Applicants Signature Date, I hereby swear or affirm that, CoApplicants Signature Date, Lienholders Signature, PROOF OF LIABILITY INSURANCE MUST, PROVIDED FOR BY LAW BEFORE THIS, TO AVOID PENALTY AND INTEREST, Witness Witness, Sworn and subscribed before me, File must be submitted within, Notary Public Signature Printed, and RECEIVEDREJECTION DATES. These are required to be completed with highest awareness of detail.

The best ways to prepare louisiana vehicle title app pdf part 3

4. To go forward, this fourth section will require filling in several blanks. Included in these are CONVERSION Old License Plate, New License Plate Number Use, TRANSFER OF PLATE License plate, YEAR MAKE VIN, and transferred to the vehicle, LOST STOLEN OR REPLACEMENT, PLATE, STICKER, License Plate Number, TITLE CORRECTION, Error, Correct To, FARM USE STATEMENT, E I do declare that I am a bona, and Owners Signature F OUT OF STATE, which you'll find essential to moving forward with this particular form.

Part number 4 of submitting louisiana vehicle title app pdf

5. To wrap up your document, this particular subsection includes a few extra fields. Filling out Owners Signature F OUT OF STATE, Printed name of owner, was domiciled in Louisiana on, declare that the, MAKE, MODEL, VIN, DISCLOSURE OF SALVAGE, swear under penalties of perjury, Printed name of owner, the title covering the vehicle, in accordance with, MAKE Louisiana RS has been, Reconstructed Vehicle, and Salvaged Vehicle should wrap up everything and you will be done before you know it!

the title covering the vehicle, Printed name of owner, and MAKE Louisiana RS  has been inside louisiana vehicle title app pdf

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