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Louisiana Vehicle Application Form

The Louisiana Vehicle Application form is a crucial document for anyone looking to register a vehicle in Louisiana. This form collects essential information about the vehicle and its owner, ensuring compliance with state regulations. Properly completing this form is vital to avoid delays or rejections in the registration process.

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The Louisiana Vehicle Application form is a crucial document for vehicle registration in the state. It serves multiple purposes, including the transfer of ownership, the application for a duplicate title, and the reporting of various vehicle-related changes. Applicants must provide essential information such as the vehicle identification number (VIN), make, model, year, and color, as well as details about the owner and any joint owners. The form also requires the owner’s principal residence address, which may vary depending on whether the vehicle is used for personal or commercial purposes. Furthermore, the application addresses specific circumstances such as lienholder information for vehicles under a security agreement and the need for proof of liability insurance. It also includes sections for various declarations, such as farm use and out-of-state residency, ensuring that all relevant information is captured. Additionally, the form emphasizes the importance of timely submission to avoid penalties and interest, reinforcing the necessity of compliance with state regulations. With clear instructions and a structured layout, this form facilitates the efficient processing of vehicle registrations and related requests.

Louisiana Vehicle Application 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

City

Parish

State/Zip

Are you residing within a special tax district or ward?

YES

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

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

(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

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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Documents used along the form

When applying for a vehicle in Louisiana, several additional forms and documents may be required alongside the Louisiana Vehicle Application form. Each of these documents serves a specific purpose in ensuring that the application process is smooth and compliant with state regulations.

Proof of Liability Insurance: This document verifies that the applicant has the required vehicle liability insurance coverage as mandated by Louisiana law. It must be submitted before the application can be processed.
Duplicate Title Affidavit: If the original title has been lost or never received, this affidavit must be signed by the owner and notarized. It requests a duplicate title and includes a statement to hold the Commissioner harmless if the original title is obtained by someone else.
Operating Agreement Documentation: To establish a clear management structure in your LLC, use the essential Operating Agreement form resources to protect your rights and responsibilities as a member.
Affidavit of Non-Possession of Title by Lienholder: This form is necessary when the lienholder has not received the title. It must be signed by the lienholder and notarized, affirming that the title was never received.
Farm Use Statement: For applicants who are bona fide farmers, this statement declares that the vehicle is primarily used for farming purposes. It must include details about the farm and the owner's signature.
Out of State Declaration: If the vehicle was domiciled in Louisiana but is being registered from another state, this declaration must be completed. It confirms the vehicle's previous domicile and includes the owner's printed name.

These documents are crucial for a successful vehicle registration process in Louisiana. Ensuring that all required forms are completed accurately will help avoid delays and potential issues with your application.

Key takeaways

When filling out the Louisiana Vehicle Application form, keep these key takeaways in mind:

Complete All Required Information: Ensure that you fill out every section that requires information. Missing details can lead to rejection of your application.
Provide Accurate Personal Information: Include your name, address, and driver's license or EIN. If there is a joint owner, make sure to add their information as well.
Understand Your Residency Status: Indicate whether you reside within a municipality or special tax district. This can affect your fees and taxes.
Submit on Time: File your application within 40 days of purchase to avoid penalties and interest. For mobile homes, the deadline is the 20th of the month following delivery.
Insurance Proof is Mandatory: Before your application can be processed, you must provide proof of liability insurance as required by law.

↓ Louisiana Vehicle Application PDF