Fillable Wisconsin Dealer Autocycle Title/License Plate Application How To (Wisconsin)

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Wisconsin Dealer Autocycle Title/License Plate Application How To (Wisconsin)

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Wisconsin Dealer Autocycle Title/License Plate Application
MV17 8/2020 Pursuant to Chapter 340, 341.08, 342.06 WI Statutes Wisconsin Department of Transportation
How To Complete This Application
If you have any questions regarding this application, call (608) 264-7447.
To apply for title and/or license plates for your vehicle, you must complete Sections A through D as they apply.
Include the original Certificate of Title (not a copy) for a used vehicle. Include the Manufacturer’s Certificate of Origin for a new vehicle.
Selling dealer: Complete odometer statement on Certificate of Title or Manufacturer’s Certificate of Origin.
To obtain a replacement title please use form MV2119, Replacement Title Application.
Note: The electronic record held by the department is the official vehicle title record.
This application is to be used only to title and/or register an autocycle. For other vehicle types, submit form MV11, Wisconsin Title &
License Plate Application, or Form MV15, Wisconsin Dealer Low Speed Vehicle Title & License Plate Application, as applicable.
An autocycle is defined is a motor vehicle that:
• has 3 wheels in contact with the ground
• is designed with seating that does not require operators or any occupants to straddle or sit astride it
• has a steering wheel
• is originally manufactured to meet federal motor vehicle safety standards for motorcycles under 49 CFR part 571
SECTION
A
Vehicle Owner Information
Owner/Co-owner: The names that will be on the new title.
“And” means all owners must sign the title to transfer
ownership. “Or” means only one owner must sign the title.
Social Security Number and Driver License Number:
If you are applying as an individual, you are required to provide
your Social Security Number, pursuant to 1997 Act 191, for the
purposes of ss.49.22, Wis. Stats. Under the Social Security Act,
42 USCS.405, (C)(i), the department and federal agencies may
use the Social Security Number for purposes authorized by law.
FEIN: Federal Employer Identification Number is required
for corporations or other non-individual owners.
Consent to Purchase: If an owner is under 18, a legal
custodian, parent or guardian must complete this section.
Invisible disability notice to law enforcement form:
wisconsindmv.gov/inv-dis or at DMV Service Centers.
B
Vehicle Information
Salvage:
•
Vehicle less than 7 years old which has been damaged by
collision or other occurrence to the extent that the cost of
repairing the vehicle would exceed 70% of fair market value.
•
A vehicle last titled in another state as a salvage vehicle.
Note: You cannot drive a salvage vehicle until it passes a
salvage inspection, except to travel to the inspection site.
Police/Taxi: A vehicle that has been used, or will be used,
as a police vehicle or taxi.
Flood Damaged: A vehicle damaged by water to the
extent that the estimated or actual repair costs, whichever
is greater, exceeds 70% of fair market value.
Hail Damaged: A vehicle less than 7 years old damaged
solely by hail to the extent that the estimated or actual
cost, whichever is greater, to repair the vehicle exceeds
70% of its fair market value, and repaired without
replacing any exterior parts, s.340.01 Wis. Stats.
C
Loan Information: If you borrowed money for this vehicle,
contact the lender for the correct information. Please show
complete mailing address. Loan filing fee is $10.00. Any title with
a lien (loan) listed on or after July 30, 2012, will be sent to the lien
holder. Vehicle owners will receive a Confirmation of Ownership
and will receive the actual title when all liens are cleared.
D
Fees
Title Fee: Applying for a title only (without plates) does not allow
you to legally operate your vehicle on a Wisconsin roadway. To
legally operate your vehicle, you must also apply for Wisconsin
license plates.
License Plate Fee: Two-year registration only. Plates expire
at the end of April in even-numbered years. Use chart below to
determine license plate fee due based on your date of operation.
Wheel Tax: In addition to the annual autocycle (ACY) registration
fee, an annual wheel tax applies when purchasing or renewing
license plates if the vehicle is kept in a municipality or county that
requires a wheel tax. Please visit wisconsindmv.gov/wheeltax for
a complete list of wheel taxes.
State Sales Tax: Pay 5% sales tax unless one of the reasons
below applies. List the code number and information requested:
CODE
REASON
1.
Motor vehicle previously titled in Wisconsin and purchased
from spouse, parent, child, spouse’s parent, child’s
spouse, stepparent or stepchild. List appropriate one.
2.
Purchaser is Common or Contract Carrier using the
vehicle exclusively as such. Show Authority Number.
3.
Lessor reporting gross receipts from rental or lease.
Show Seller’s Permit or Use Tax Number.
4.
Purchaser is State of WI or other Federal
or WI government unit or agency.
5.
Tax paid to another state. List state and submit proof.
6.
Purchaser is not a resident of WI and will not use motor vehicle
in WI except to remove it from WI. Show residence state.
8.
Religious, charitable, educational or other nonprofit
organization. List appropriate one and CES#.
9.
Other: List reason.
Autocycle (ACY) License Plate (Registration) Fees
Month
MAY
JUN
JUL
AUG
SEP
OCT
NOV
DEC
JAN
FEB
MAR
APR
Fee
$45.00
$41.25
$37.50
$33.75
$30.00
$26.25
$22.50
$18.75
$15.00
$11.25
$7.50
$3.75
LOCAL SALES TAX —
Determine which county the vehicle will be kept in and multiply the amount subject to tax by the tax rate if any) for that
county. For county tax rate information, visit https://www.revenue.wi.gov/Pages/Apps/strb.aspx.
For all tax questions, call the Wisconsin Department of Revenue at (608) 266-2776.
Release of Nonexempt Information
Under the Wisconsin open records law, the Wisconsin Department of Transportation must provide information from its records to requesters.
If you do not want your name and address included in requests we receive for ten or more records, you may ask the department to withhold
your name and address from those lists by checking the boxes at the bottom of the application.
WISCONSIN DEALER AUTOCYCLE TITLE &
LICENSE PLATE APPLICATION
MV17 8/2020
Processor ID No. Received – Date – Opened
Title No. – New License Plate No.
Amount Received – Document No.
Check Cash
DO NOT WRITE ABOVE THIS LINE. Complete form using BLUE or BLACK INK.
Owner Legal Name (Last, First, Middle Initial OR Business Name)
Birth Date
Owner Social Security # or Driver License # or FEIN – Required
Co-Owner Name (if any) (Last, First, Middle Initial)
(check one)
OR
AND
Birth Date
Co-Owner Social Security # or Driver License # or FEIN – Required
Street Address (include PO Box if applicable) City State ZIP Code
Owner Daytime (Area Code) Telephone Number
If this is a leased vehicle, list Lessee Name (Last, First, Middle Initial)
Lessee Social Security # or Driver License # or FEIN – Required
Lessee Street Address City State ZIP Code
Lessee Daytime (Area Code) Telephone Number
UNDER 18
YEARS OLD
I certify that I have legal custody of the person named as owner
and consent to the purchase by such person and registration of
the vehicle described in the applicant’s name.
Date Signed
Signature (legal custodian, parent or guardian)
X
NOTARY
PUBLIC
County
Date my commission expires
Date subscribed and sworn to before me
Notary Signature
X
Vehicle Identification Number Year Make Type (Autocycle Only.) Color Fleet No. (Optional)
Wisconsin License Plate to Transfer or Temporary Plate
Plate Type
Check if plates transferred between spouses/same-sex domestic partners.
License plates cannot be transferred between other family members.
Date You First Drove This Vehicle in Wisconsin
Check any that apply (see instructions)
Title Only
Salvage
Police
Taxi
Flood Damaged
Hail Damaged
Vehicle is kept in County
City
Village
Town
(check one)
OF:
OF:
Section C - Loan Information
Use this section if you are adding a new lien. Any title with a lien listed after July 30, 2012, will be sent to the lien holder rather than the owner.
LIEN HOLDER #1 LIEN HOLDER #2
Name of Lending Agency(s) or Person(s)
Name of Lending Agency(s) or Person(s)
Street Address (include PO Box if applicable)
Street Address (include PO Box if applicable)
City State ZIP Code
City
State
ZIP
Code
Secured Party Number(s)
(Area Code) Telephone Number
Secured Party Number(s)
(Area Code) Telephone Number
Section D - Fees
Tax Statement
Original Title Fee – $164.50 $
Purchase Price $
(WARNING: It is a crime to understate the purchase price)
Less trade-in allowance $
Amount subject to tax $
State Sales Tax (amount subject to tax
×
0.05) $
Local Sales Tax $
Loan Filing Fee – $10 (pay fee for each loan in Section C) $
License Plate Fee – $45 $
Wheel Tax $
ENTER FEE TOTAL $
Vehicle Owner Certification
All parties certify with their signature that to the best of their knowledge the
information and statements on this application are true and correct. The prior
Date Vehicle Purchased
Used
New
Date Vehicle Delivered
Trade-in
Vehicle
Year
Make
Vehicle Identification Number
If tax exempt, enter code and reason (see instructions)
LICENSED DEALER’S STATEMENT OF SALE AND WARRANTY
For value received I hereby sell, assign or trade the vehicle described on this
document to the purchaser(s) named in Section A and I certify that all liens shown
on the Certificate of Title are paid. Wisconsin Dealer signature also serves as
evidence of application for title/registration and payment of fees.
Dealer Name
Dealer Number
(Area Code) Telephone Number
Name of Selling Dealer’s Authorized Agent
X
owner’s odometer statement has been shown to the applicant and a copy
of this completed application has been furnished the applicant. Odometer
information must be completed on title or manufacturer’s certificate of origin.
X
(Owner Signature) (Date)
X
(Co-Owner Signature) (Date)
(Signature of Selling Dealer’s Authorized Agent) (Date)
Wisconsin Dealers: Submit state, county and local tax with form ST-12
to WI Department of Revenue
MAIL
the
original vehicle title
(not a copy), application and check to:
WI Dept. of Transportation
PO Box 8070, Madison WI 53707-8070
Make Check Payable To: Registration Fee Trust
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Wisconsin Dealer Autocycle TitleLicense Plate Application How To (Wisconsin)

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Completed 9 February 2021

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