Fillable Vermont - Form VD119 Vehicle Reg Tax and Title Application

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Vermont - Form VD119 Vehicle Reg Tax and Title Application

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The Vermont - Form VD119 Vehicle Reg Tax and Title Application form is 2 pages long and contains:

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File type: PDF

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Vermont Registration Tax & Title Application
OLD #1 Title Brands
490C
490P
NNR
Expires
NEW #1 In Lieu Plate Reg Type
NEW #2 Temp Plate Date Index #
2 Year
LP
225
227
231
232
233
452
453
454
455
465
1
Vehicle is Owned or Leased
Email
Owner/Lessee
Name
EIN # (if business)
Phone
Address where you get mail
Address where you live
City
State
ZIP
City
State
ZIP
If name has changed, list previous name(s):
Gender
Date of birth
Co-
Owner/Lessor
Name
EIN # (if business)
Phone
Address where you get mail
Address where you live
City State ZIP City State ZIP
If name has changed, list previous name(s):
Gender
Date of birth
2
Spouses
Joint Tenants
Tenants In Common
Business Partners
Transfer on Death
(requires form T-07)
3A
Lienholder Name
Date of loan
VT license # (if individual)
Date of birth (if individual)
Lienholder Address
3B
Name of person or
company vehicle
acquired from
Date purchased
VT Dealer number
Address of person or
company vehicle
acquired from
Signature of person
or company (agent)
vehicle acquired from
4
New Registration (421) Lease Buy-Out (421) Title Only
Plate #
Expires (month/year)
Registration/Plate Type
Car (19) Truck (27)
Trailer (26, 25, 06) Motorcycle (18)
________________ | _____
see instructions (#)
Renew (475) IRP Tax & Title Exempt Title (25yr)
Transfer (431) Weight Change
5
Make
Model
Model Year
Body Type
Color
Mileage (No Tenths)
Miles
Km
Hours
Serial Number (VIN)
# of Cylinders
New Used
Rebuilt
Gas Diesel Propane
Hybrid Electric Other
Trucks
# of Axles
Brake Type
HYD Air Other
Trailers
Length x Width
Empty Weight
Cycle/ATV
# of Wheels
Jitney
# of Passengers
Empty Weight
Loaded Weight
Loaded Weight
1500 or less (26) 1501 or more (25)
CC’s
Empty Weight
6
Purchase Price
7
Purchaser of old vehicle
9
Registration (1)
Credit for Trade
City State Date of Sale
Do Not Write In Shaded Areas
Tax (2)
NADA Value
Year
Make
Plate
Tax Exempt #
Title (3)
Adjustments
VIN
Transfer (4)
Net Taxable
Statements and warrants herein are certified under penalty of 23 V.S.A.
§202, §203, §2082, and 32 V.S.A. §§ 8901-8915.
Return #
Renewal Fee
Rater #
Warranty (12)
8
The owner certifies that this vehicle 1) is properly equipped and in good mechanical condition; 2) was placed into use on or
before the date this application was signed; 3) currently has liability insurance in effect as required by 23 V.S.A. §800 (a). If
transfer of plates, the owner and/or this vehicle are not under suspension pursuant to 23 V,S,A, §3009(b). As the applicant
for registration of a commercial motor vehicle, I hereby declare that I have knowledge of the Federal Motor Carrier Safety
Regulations, Title 49 of the Code of Federal Regulations, as adopted by the State of Vermont.
Application Must be Signed (in ink)
Fuel User (31)
Other
Total
Signature (Owner/Lessee)
Date
Signature (Co-Owner/Lessor)
click to sign
signature
click to edit
dd mmm yyyy
click to sign
signature
click to edit
Vermont Registration Tax & Title Application
OLD #1 Title Brands
490C
490P
NNR
Expires
NEW #1 In Lieu Plate Reg Type
NEW #2 Temp Plate Date Index #
2 Year
LP
225
227
231
232
233
452
453
454
455
465
1
Vehicle is Owned or Leased
Email
Owner/Lessee
Name
EIN # (if business)
Phone
Address where you get mail
Address where you live
City
State
ZIP
City
State
ZIP
If name has changed, list previous name(s):
Gender
Date of birth
Co-
Owner/Lessor
Name
EIN # (if business)
Phone
Address where you get mail
Address where you live
City State ZIP City State ZIP
If name has changed, list previous name(s):
Gender
Date of birth
VT license # (if individual)
2
Spouses
Joint Tenants
Tenants In Common
Business Partners
Transfer on Death
(requires form T-07)
3A
Lienholder Name
Date of loan
Date of birth (if individual)
Lienholder Address
3B
Name of person or
company vehicle
acquired from
Date purchased
VT Dealer number
Address of person or
company vehicle
acquired from
Signature of person
or company (agent)
vehicle acquired from
4
New Registration (421) Lease Buy-Out (421) Title Only
Plate #
Expires (month/year)
Registration/Plate Type
Car (19) Truck (27)
Trailer (26, 25, 06) Motorcycle (18)
________________ | _____
see instructions (#)
Renew (475) IRP Tax & Title Exempt Title (25yr)
Transfer (431) Weight Change
5
Make
Model
Model Year
Body Type
Color
Mileage (No Tenths)
Miles
Km
Hours
Serial Number (VIN)
# of Cylinders
New Used
Rebuilt
Gas Diesel Propane
Hybrid Electric Other
Trucks
# of Axles
Brake Type
HYD Air Other
Trailers
Length x Width
Empty Weight
Cycle/ATV
# of Wheels
Jitney
# of Passengers
Empty Weight
Loaded Weight
Loaded Weight
1500 or less (26) 1501 or more (25)
CC’s
Empty Weight
6
Purchase Price
7
Purchaser of old vehicle
9
Registration (1)
Credit for Trade
City State Date of Sale
Do Not Write In Shaded Areas
Tax (2)
NADA Value
Year
Make
Plate
Tax Exempt #
Title (3)
Adjustments
VIN
Transfer (4)
Net Taxable
Statements and warrants herein are certified under penalty of 23 V.S.A.
§202, §203, §2082, and 32 V.S.A. §§ 8901-8915.
Return #
Renewal Fee
Rater #
Warranty (12)
8
The owner certifies that this vehicle 1) is properly equipped and in good mechanical condition; 2) was placed into use on or
before the date this application was signed; 3) currently has liability insurance in effect as required by 23 V.S.A. §800 (a). If
transfer of plates, the owner and/or this vehicle are not under suspension pursuant to 23 V,S,A, §3009(b). As the applicant
for registration of a commercial motor vehicle, I hereby declare that I have knowledge of the Federal Motor Carrier Safety
Regulations, Title 49 of the Code of Federal Regulations, as adopted by the State of Vermont.
Application Must be Signed (in ink)
Fuel User (31)
Other
Total
Signature (Owner/Lessee)
Date
Signature (Co-Owner/Lessor)
click to sign
signature
click to edit
dd mmm yyyy
click to sign
signature
click to edit
VIN Verification (use DMV form VT-010 for VIN Verification)
• All used vehicles with out of state titles being
registered/titled in the applicant’s name for the first time are
required to procure a VIN verification from the personnel
listed below, unless purchased directly from a licensed
dealer.
• Vehicles with Salvage Documentation from any state,
including Vermont, are required to procure a VIN
verification from the Vermont personnel listed below.
• Vehicles being titled under bond are required to procure a
VIN verification from the Vermont personnel listed below.
• Vehicles with registrations from any foreign country,
including Canada are required to procure a VIN verification
from the Vermont personnel listed below.
• Vehicles over 25 years old, for which a Vermont resident is
seeking an "exempt title" are required to procure a VIN
verification from the Vermont personnel listed below.
• Motorcycles which are not titleable but are 500 cc’s or more
and have not been previously registered/titled to the
applicant or have not been previously registered in Vermont
are required to procure a VIN verification from the
personnel listed below.
Registration/Plate Types (Additional Form(s) required for most of the following plates)
Agriculture Farm Use Only (01)
Amateur Radio Operator (42)
American Legion (38)
Antique (03) (AN)
ATV (02)
Building Bright Futures (55)
Conservation Plate (48, 57, 65, 66, 67)
Disabled Plate
EMS (46)
Exhibition (09) (Ex)
Firefighter (40)
Freemasons (54)
Gold Star Family (16)
Jitney/Rental (37)
Lions Club (51)
Motor Bus (04, 05)
Motor Driven Cycle (moped) (17)
Motor Home (19)
Municipal (15)
National Guard (41)
Off-Highway Tractor (24)
Pearl Harbor (44)
POW (23)
Purple Heart (47)
Rotary (53)
School Bus (19)
Sheriff (43)
Special Purpose Truck Cat I (11)
Special Purpose Truck Cat II (20)
State (22)
Street Rod (56)
US Veteran (49)
US Veteran Afghanistan (61)
US Veteran Gulf War (62)
US Veteran Iraq (63)
US Veteran Korean War (59)
US Veteran Motorcycle (49)
US Veteran Vietnam War (60)
US Veteran World War II (58)
US Veteran, Disabled (08)
Veterans of Foreign Wars, VFW (52)
Vietnam Vets of America, VVA (50)
Volunteer (28)
Transaction Types
• Register for First time - New plates will be issued. Complete
entire application.
• Renew - Complete Sections 1, 2, 4, 5 and 8.
• Transfer - Complete Sections 1, 2, 3, 4, 5, 6, 7 and 8.
• Lease Buy-Out - Complete Sections 1, 2, 3 4, 5, 6 and 8.
• Title Only - Complete entire application. Tax is due when
applying for Title.
• IRP Tax & Title - Must also complete IRP Application. IRP
transactions are only processed in the Montpelier office.
Questions contact Commercial Vehicle Office
802.828.2071.
• Exempt Title - Must also complete form T25. Vehicle must
be over 25 years old, VIN verification is required.
• Weight Change - Complete Sections 1, 2, 3, 4, 5 and 8.
Types of Vehicle Ownership
• Tenants by the Entirety/Spouses (TEN ENT) - Married couples (including Civil Unions), where ownership of property is treated as
though the couple were a single legal person. Owners have a right of survivorship, if one owner dies, interest in the property will pass to
the surviving owner avoiding probate.
• Joint Tenants (JTEN) - Co-owners have a right of survivorship, if one owner dies, interest in the property will pass to the surviving owner
avoiding probate.
• Tenants in Common (TEN COM) - No right of survivorship, if one owner dies, interest in the property will be part of his or her estate.
• Business Partners (PTNERS) - No right of survivorship, if one owner dies, interest in the property will be part of his or her estate.
• Transfer on Death (TOD) – One owner only, DMV form VT-007 required.
VD-119 200M 02/2019 MTC
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Vermont - Form VD119 Vehicle Reg Tax and Title Application

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Completed 25 May 2020

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