TYPEWRITE or PRINT IN INK - Improperly filled application will not be accepted.
License Plate No.: Registration Expiration:
Make: Emblem No.:
Vehicle Identification No.:
Registered Owner of Record:
Address:
The undersigned certifies that the Certificate of Registration for the above described vehicle has
been ❑ lost ❑ stolen ❑ mutilated ❑ defaced, and hereby requests the issuance of a
duplicate, which issuance shall void the original certificate.
DEFACED OR MUTILATED
CERTIFICATE MUST BE
SURRENDERED WITH
THIS APPLICATION.
OFFICE USE ONLY
Signature of Registered Owner or Record
Number and Street City Zip Code
Application accepted and
duplicate issued
Date - Clerk
If firm, print name and title of person signing.
CITY AND COUNTY OF HONOLULU
DEPARTMENT OF CUSTOMER SERVICES
DIVISION OF MOTOR VEHICLE, LICENSING AND PERMITS
P.O. BOX 30330
HONOLULU, HAWAII 96820-0330
APPLICATION FOR DUPLICATE
Motor Vehicle Certificate of Registration
CS-L(MVR) 5
(Rev. 9/03)
