Vehicle Services Bureau
Request for
State Assigned VIN
VIN Tag Fee - $5.15
Additional $20.09 for TRP if needed.
Fees include 3% administration fee per MCA 61-3-111
Fees and taxes may be due upon registration.
This application must be accompanied by the Montana Title (or Application for Montana Title)
and a Statement of Inspection (Level 1) for the vehicle described below.
SPECIAL INSTRUCTIONS: Holes will need to be drilled by the applicant to finalize the inspection. A
hammer, cordless drill and 1/8 inch drill bit will need to be taken to the local driver license station
once you receive the identification tag and rivets. If a cordless drill and drill bit are not available, a
return trip must be made to finalize the inspection.
I/we,
(Printed Name)
residing at
(Street Address, City, State, Zip Code)
certify that I am/we are the person(s) named on this form as applicant(s) for an identification number assigned by the State
of Montana for the vehicle described below because (check one):
Number was altered Number was removed Cannot locate number Vehicle is homemade
State why the identification number was altered or removed:
Make of vehicle: Style of body:
Year:
Original identification number:
Title number: License plate or decal number:
Under penalty of law (MCA 45-7-203), I certify that the statements made and information contained on this form are true and
correct to the best of my knowledge, information, and belief; I am the person named on this form; and, if signing for a
business entity or trust, I have full authority to do so.
Driver License #:
(This is my legal signature)
Date:
Applicant Signature:
Printed Name:
Email Address:
MV10B (1/18)
Montana county and state authorities reserve the right to reject any form that has been altered. This form is available in alternate formats for people with disabilities.
P.O. Box 201431, 302 N Roberts, Helena, MT 59620-1431
Phone (406) 444-3661 Fax (406) 444-0116 mvdtitleinfo@mt.gov
Phone Number:
