-
ADDITIONAL
OWNER
VEHICLE
SIGNATURES
CERTIFICATIONS
DMV USE ONLY
REMARKS:/&&)#%53%/.,9
INFORMATION
or LESSEE / ADDRESS
INFORMATION
Application for Registration,
Renewal, Replacement
or Transfer of Plates
and/or Stickers
DM V
DEPARTMENT OF TRANSPORTATION
DRIVER AND MOTOR VEHICLE SERVICES
1905 LANA AVE NE, SALEM OREGON 97314
Complete all applicable areas. MAIL TO: DMV, 1905 Lana Ave NE, Salem OR 97314; or take to any DMV office.
VEHICLE IDENTIFICATION NUMBER (VIN)
OREGON TITLE #
1
PRESENT OREGON PLATE #
YEAR
MAKE
STYLE
EQUIPMENT #
WEIGHT / LENGTH
'672
2
SPECIAL PLATES FARM ID # FLEET ACCOUNT #
DIESEL HYBRID
PLUG-IN
GAS
&,%8&5%,
HYBRID
3
NATURAL
ELECTRIC PROPANE
OTHER:
This application cannot be used to change or correct the name(s) shown on the title or to change ownership.
%QORNGVG.KPGYKVJVJGQYPGTYJQUGCFFTGUUYKNNDGWUGFHQTCNN&/8OCKNTGICTFKPIVJKUXGJKENG .KUVCFFKVKQPCNQYPGTUQP.KPGUCPF 6JKUKPPQYC[FGVGTOKPGUCRTKQTKV[QH
QYPGTUJKR+HCP[QYPGTNKUVGFWUGUCPCIGPE[CFFTGUUQP&/8TGEQTFUVJCVQYPGTOWUVDGUJQYPQP.KPG5GGTGXGTUGHQTOQTGKPHQTOCVKQP
PRINT FULL LEGAL NAME: LAST, FIRST, MIDDLE OF (check one)
OWNER OR LESSEE
ODL / ID / CUSTOMER # DATE OF BIRTH
4
RESIDENCE / BUSINESS ADDRESS - (Address will be used to update your ODL / ID Card) MAILING ADDRESS - (If different from residence)
5
CITY, STATE, ZIP CODE
COUNTY OF RESIDENCE CITY, STATE, ZIP CODE COUNTY OF MAILING
6
JOINT OWNER OR LESSEE - PRINT FULL LEGAL NAME: LAST, FIRST, MIDDLE (See “Address Change” on reverse)
ODL / ID / CUSTOMER # DATE OF BIRTH
7
JOINT OWNER OR LESSEE - PRINT FULL LEGAL NAME: LAST, FIRST, MIDDLE (See “Address Change” on reverse)
ODL / ID / CUSTOMER # DATE OF BIRTH
8
ONE-TIME MAILING ADDRESS (For this transaction only – address will not show on your customer record) VEHICLE ADDRESS - (Location of vehicle if different from residence)
9
CITY, STATE, ZIP CODE
CITY, STATE, ZIP CODE COUNTY (of vehicle address or use)
10
By signing this application, I certify:
z to one of the following: 1) If this application includes registration, and this motor vehicle is subject to the financial responsibility laws, I
am in compliance and will remain in compliance until the vehicle is transferred; or 2) if this application includes a registration renewal,
this vehicle is covered by the motor vehicle liability insurance policy listed below.
INSURANCE COMPANY (not agent) POLICY #
11
z My place of domicile (home) is in Oregon or I am otherwise eligible or required to register this vehicle under Oregon law. (ORS 803.200, ORS
803.350, and ORS 803.360).
z If this is initial registration of a tow/recovery vehicle, or initial registration or renewal of a manufactured structure toter, farm, or charitable/non-
profit, the vehicle and its use qualify for special registration and conform to the law.
z All information on this form is true and correct and agree with all applicable statements on the front and back of this form. Under Oregon law, it
is a crime to knowingly make any false statement on an application for registration (ORS 803.375). This offense is a Class A misdemeanor and
is punishable by a jail sentence of up to one year, a fine of up to $6,250, or both.
SIGNATURE OF OWNER AS SHOWN ABOVE DATE
4%,%PHONE #
12
X
SIGNATURE OF JOINT OWNER AS SHOWN ABOVE DATE
4%,%PHONE #
13
X
Passenger Vehicle Plate Type:
14
Transaction Type:
UO DUCKS
REGISTRATION / RENEWAL
REPLACEMENT PLATE(S)
DUPLICATE PLATE(S)*
REPLACE
MENT STICKER(S)
REPLACEMENT REG. CARD
PLATE TRANSFER: Plate #___________
CRATER LAKE
POLLINATOR
REMARKS:
735-268 (9-24)
STK# 300111
ONE TWO
*You can get a duplicate of one or both plates assigned to your vehicle if
DMV is currently issuing the design and type. Mark ONE or TWO above.
OTHER:
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*
CUSTOM PLATE:
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*
You must complete and attach a Custom Plate Application, Form 735-205.
WINE COUNTRY
TREE
GRAY WHALE
TRAIL BLAZERS
WILDLIFE
GROUP:
CULTURAL
SALMON
PACIFIC
WONDERLAND
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SMOKEY BEAR