Fillable form MV2119, Replacement Title Application. Note: The electronic (Bad River Band Of Lake Superior Tribe Of Chippewa Indians)

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form MV2119, Replacement Title Application. Note: The electronic (Bad River Band Of Lake Superior Tribe Of Chippewa Indians)

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The form MV2119, Replacement Title Application. Note: The electronic (Bad River Band Of Lake Superior Tribe Of Chippewa Indians) form is 4 pages long and contains:

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BROWSE BAD RIVER BAND OF LAKE SUPERIOR TRIBE OF CHIPPEWA INDIANS (WI) FORMS

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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.
License Plate Fee
Regular passenger vehicle plates are for automobiles,
vans with more space for seating people than carrying
property, and jeep-type or sport utility vehicles with a back
seat.
Regular light truck plates are based on gross weight*
and are for pick-up trucks, vans with more space for
carrying property than seating people, and jeep-type or
sport utility vehicles without a back seat.
* Gross weight – see gross weight fee schedule
License plates for other types of vehicles and special
license plates are listed in Section F on back of
application.
Miscellaneous Fees
Electric or Hybrid Surcharge and Wheel Tax for passenger cars or trucks
registered at 8,000 lbs. or less (excluding dual purpose farm vehicles):
An annual wheel tax and/or surcharge applies if you are purchasing or renewing
license plates and the vehicle is:
1) Kept in a municipality or county that requires a wheel tax. Please visit
wisconsindmv.gov/wheeltax for a complete list of taxes.
2) Electric vehicle ($100 annual surcharge).
3) Hybrid vehicle ($75 annual surcharge).
Counter Service Fee is required if you apply in person at a DMV Customer
Service Center.
Processing Fee: If application is solely to add a loan and the Secured Party is
not ling electronically, add $5 for DMV processing. Nonexempt Secured Parties
must pay an additional $20 surcharge that may not be charged to the customer.
Title/License Plate Application
MV1 5/2021
Pursuant to Chapter 340, 341.08, 342.06, WI Statutes
Wisconsin Department of Transportation
How To Complete This Application QUESTIONS: (608) 264-7447
You may be eligible to apply online, see: wisconsindmv.gov/emvpublic.
For a list of title and registration locations, visit: wisconsindmv.gov/partners.
To apply for a title and/or license plates for your vehicle, you must complete Sections A through F as they apply. Include the original Certicate
of Title (not a copy) for a used vehicle. Include the Manufacturer’s Certicate of Origin for a new vehicle. To obtain a replacement title please use
form MV2119, Replacement Title Application. Note: The electronic record held by the department is the ocial vehicle title record 342.09(4)(b).
SECTION
(Instructions continued on back of this page)
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.
Opt Out: You may remove your name(s) from mailing lists
that contain 10 or more individual names by checking the box.
Businesses are not eligible for opt out.
Social Security Number and Driver License Number:
If you are applying as an individual, you are required to provide
your Social Security Number (SSN), under s.342.06(1)(eg) Wis.
Stats. If you have a WI driver license, you may provide that
number instead of your SSN. Under the Social Security Act,
42 USCs. 405,(c)(2)(C) (i), the department and other state and
federal agencies may use the SSN for purposes authorized by
law. FEIN: Federal Employer Identication Number is required
for corporations or other non-individual owners.
B
Vehicle Information – Mandatory Display
To legally operate a car or light truck, you must display license
plates within two business days of purchase. Provide either a
license plate to transfer or a temporary plate number.
License Plate Transfers: The following license plate types
belong to you. No charge to transfer current license plates.
Include renewal fee if expiring in less than 30 days. You may
transfer them from a vehicle you no longer use to another vehicle
of the same type that belongs to you, your spouse, or domestic
partner (as dened by Ch. 770 Wis. Statutes):
Auto (passenger vehicle)
Driver Ed
Farm Truck (up to 12,000 lbs.)
Truck (up to 8,000 lbs.)
Municipal
Dual Purpose Veh.(up to 8,000 lbs.)
Motorcycle
Motor Home
Dual Purpose Farm (up to 8,000 lbs.)
Temporary Plate: If you do not have a plate to transfer, take your
application to a DMV Customer Service Center that processes
vehicle registration or an agent authorized by DMV to obtain a
metal or temporary plate. An agent will charge a $3 temporary
plate fee, give you a temporary plate valid for 90 days and may
also charge a service fee. For locations please see:
wisconsindmv.gov/centers or wisconsindmv.gov/partners
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. Refer to Wisconsin Statutes 341.268 for denition of
homemade, reconstructed, replica and/or street modied
vehicles.
D
Loan Information: If you borrowed money for this vehicle,
contact the lender for the correct information. Please show
complete mailing address. 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 Conrmation of Ownership and will receive the
actual title when all liens are cleared.
E
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.
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. List Authority Number.
3. Lessor reporting gross receipts from rental or lease. List 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. List residence state.
7. Purchaser is a WI dealer for a vehicle purchased solely for resale
8. Religious, charitable, educational or other nonprot organization.
List appropriate one and CES#.
9. Miscellaneous. Specify in ‘if other, list reason’
Go to Application
Gross Weight
Not Over A B C D E F G H J
4,500 $ 100.00 $ 118.00 $ 44.00 $ 26.00 – $ 25.00 $ 50.00 – $ 43.00
5,000 – – – – – – – $ 48.50 –
6,000 100.00 118.00 54.50 36.50 – 25.00 50.00 – 43.00
8,000 106.00 124.00 61.00 43.00 – 26.50 53.00 55.00 44.50
10,000 155.00 173.00 78.00 60.00 – 38.75 77.50 – 56.75
12,000 209.00 227.00 95.50 77.50 *$ 45.00 52.25 104.50 67.50 70.25
14,000 – – – – – 61.50 246.00 – –
16,000 283.00 301.00 127.50 109.50 70.75 70.75 283.00 80.50 88.75
20,000 356.00 374.00 160.00 142.00 89.00 89.00 356.00 93.50 107.00
26,000 475.00 493.00 208.50 190.50 118.75 118.75 475.00 106.50 136.75
32,000 609.00 627.00 263.00 245.00 152.25 152.25 609.00 119.50 170.25
38,000 772.00 790.00 327.50 309.50 193.00 193.00 772.00 119.50 211.00
44,000 921.00 939.00 389.00 371.00 230.25 230.25 921.00 119.50 248.25
50,000 1,063.00 1,081.00 443.50 425.50 265.75 265.75 1,063.00 119.50 283.75
54,000 1,135.00 1,153.00 474.00 456.00 283.75 283.00 1,135.00 119.50 301.75
56,000 1,209.00 1,227.00 505.00 487.00 302.25 302.25 1,209.00 119.50 320.25
62,000 1,367.00 1,385.00 569.50 551.50 341.75 341.75 1,367.00 119.50 359.75
68,000 1,543.00 1,561.00 640.50 622.50 385.75 385.75 1,543.00 119.50 403.75
73,000 1,755.00 1,773.00 727.50 709.50 438.75 438.75 1,755.00 119.50 456.75
76,000 2,081.00 2,099.00 856.50 838.50 520.25 520.25 2,081.00 119.50 538.25
80,000 2,560.00 2,578.00 1,050.00 1,032.00 640.00 640.00 2,560.00 119.50 658.00
F
License Plate Type: See page 2 of application. If you are
not purchasing regular passenger vehicle or light truck plates:
Determine the plate type you need.
Write the plate type and fee in Section E.
Complete all applicable information in Section F.
Insurance must be on le with DMV for the following vehicle
types:
For Hire Auto
Driver Education
Bus
Human Service Vehicle
For Hire Carrier
Rental
Owner Signature(s): Owner(s) shown in Section A must sign.
If an owner is under 18, also complete Section H on back.
Release of Non-Exempt Information: Under 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. Form MV3592 – Request to
Withhold Name and Address is available at DMV Customer
Service Centers and at: wisconsindmv.gov/vehicleforms.
ADA: The Wisconsin Department of Transportation complies with
the Americans with Disabilities Act.
Invisible disability notice to law enforcement form: wisconsindmv.
gov/inv-dis or at DMV Service Centers.
H
Consent to Purchase: See page 2 of application. If an
owner is under 18, a legal custodian, parent or guardian must
complete this section.
GROSS WEIGHT FEE SCHEDULE
Gross Weight: Vehicle weight plus the weight of any load you plan
to carry. This schedule is not for autos, motorcycles, mopeds and
RV trailers.
See Section F for column to use in determining gross weight fee.
Enter Gross Weight, Registration Period and fees in Section E.
Fees are annual, except that plates for * FARM TRUCKS 12,000 lbs.
gross weight or less which are good for two years and expire in
February of even numbered years.
Quarterly Registration: Trucks, Tractors, Buses, Motor Homes,
and Trailers registered for more than 8,000 pounds gross weight
may register quarterly. Farm Trucks and vehicles registered at
special or reduced fees are not eligible, except those registered for
hauling dairy or raw forest products. Calculate the fee as follows:
Annual fee divided by 4, multiplied by number of quarters, plus $5.
Consecutive Monthly Registration: Trucks, Trailers, or Truck
Tractors transporting certain commodities are eligible. This
requires a minimum of 3 consecutive months registration.
Complete Consecutive Monthly Registration block in Section F.
Calculate fee as follows: Annual fee divided by 12, multiplied by
number of months, plus $15.
Enter the number of months of registration you want (minimum
of 3 months) and the beginning month of registration, for
example: 3/February.
Note: If manufactured housing unit, contact the Department of
Safety and Professional Services at: (608) 266-2112.
Registration Periods
PERIOD HTK, TOR, BUS, TRL MOTOR HOME
1st Qtr. January–March April–June
2nd Qtr. April–June July–September
3rd Qtr. July–September October–December
4th Qtr. October–December January–March
Annual January–December April–March
DO NOT WRITE ABOVE THIS LINE. Complete form using BLUE or BLACK INK.
WISCONSIN TITLE & LICENSE
PLATE APPLICATION
MV1-1 5/2021
Title No. – New License Plate No.
Amount Received – Document No.
Check Cash CC
Processor ID No.
Received – Date – Opened
Check any that apply (see instructions)
Title Only
Salvage
Police
Flood Damaged
Hail Damaged
Homemade
Taxi
Replica
Street Modified
Reconstructed
Section A – New Vehicle Owner Information
Owner Legal Name (Last, First, Middle Initial OR Business Name)
Opt Out regarding open records laws (see instructions)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Birth Date
– –
M M D D Y Y Y Y
Owner Social Security Number – Required
– –
OR
1 2 3 4 5 6 7 8 9
Wisconsin Driver License Number – Required
– – –
OR
1 2 3 4 5 6 7 8 9 10 11 12 13 14
FEIN Number (if company owned) – Required
–
1 2 3 4 5 6 7 8 9
Co-Owner Name (if any) (Last, First, Middle Initial)
(check one)
OR
AND
Birth Date
– –
M M D D Y Y Y Y
Co-Owner Social Security # or Driver License # or FEIN Number – Required
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Street Address (include P.O. Box if applicable)
City
State ZIP Code Owner Day time (Area Code) Telephone Number
If this is a leased vehicle, list Lessee Name Lessee Social Security # or Driver License # or FEIN Number – Required
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Lessee Street Address City State ZIP Code Lessee Day time (Area Code) Telephone Number
Section B – Vehicle Information
Vehicle Identication Number (standard VIN has 17 characters)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
WI License Plate to Transfer or Temporary Plate
1 2 3 4 5 6 7 8
Plate Type
Year Make Type (Car, Truck, Van, etc.) Color Fleet No. (Optional) Date You First Drove This Vehicle in Wisconsin
Check box if plates transferred between spouses/domestic partners (Ch. 770).
License plates cannot be transferred between other family members.
Vehicle is kept in County City Village Town (check one)
OF:
OF:
Section D – Loan Information – Use this section if you are adding a new lien. Use form MV2051 to list second lender, attach to MV1
Name of Lending Agency(s) or Person(s) Secured Party Number(s)
1 2 3 4 5 6 7 8
(Area Code) Telephone Number
Street Address (include P.O. Box if applicable) City State ZIP Code
Section C – Non-Operation
The vehicle described on this application has not been operated upon public highways between dates indicated. From: Through:
Section E – Fees
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 x 0.05) $
Local Sales Tax (see instructions) $
Loan Filing Fee – $10 (pay fee for each loan in Section D) $
License Plate Fee – Required (check one) $
Passenger Vehicle $85
Light Truck (private operation only):
4,500 pounds gross weight or less $100
6,000 pounds gross weight or less $100
8,000 pounds gross weight or less $106
Other License Plate Types (see information at right)
Miscellaneous Fees (see instructions to determine if any apply)
Annual Electric or Hybrid Vehicle Surcharge $
Wheel Tax $
Motor Carrier Class Fee from Section F $
Temporary Plate Fee – $3 $
(only if no plate to transfer; and if applying at an authorized agent)
Counter Service Fee – $5 (if you apply in person at WisDOT) $
Processing Fee $
ENTER FEE TOTAL $
Pay title fee if you are changing the owner(s) on the title, or titling the
vehicle in Wisconsin for the rst time. To obtain a replacement title
please use form MV2119, Replacement Title Application.
See instructions to determine which taxes apply.
If tax exempt, enter code
If tax exempt selected is: 1 Qualifying Family Member
Enter qualifying family member relationship
If other, list reason
For other plate types see Section F on back of this page.
Enter plate type
and gross weight if applicable
and registration period
Note: For Heavy Vehicles that qualify for Consecutive Monthly or
Quarterly registration, see back page of instructions for more
information.
MAIL the original vehicle title (not a copy), application and check to:
WI Dept. of Transportation
P.O. Box 7949
Madison WI 53707-7949
Make Check Payable To:
Registration Fee Trust
PAGE 2 MUST ALSO BE COMPLETED
Clear
Instructions
✔
164.50
164.50
Section F – License Plate Types
Vehicle type and use determines the vehicle registration. Fees shown are annual unless otherwise indicated.
Automobile
AUT* Passenger Vehicle/Auto Fee = $85. Check if
TMP Intransit/Temporary Operation 30/90 day plate to operate a vehicle except buses,
For Hire or IRP vehicles. Fee = $3.
Motorcycle
CYC* Motorcycle of less than 1,500 lbs. two-year registration only.
Plates expire in April of even numbered years. Fee = $23
MPD Moped (a maximum speed of 30 mph, 50 cc or less if automatic transmission, 130 cc or less if
operative pedals) Two-year registration only - plates expire in April of even numbered years. Fee = $23
Recreation
MTM* Motor Home used as temporary or recreational dwelling. Fee = Column “H” of fee schedule.
RVT RV Trailer (walls rigid, collapsible or non-collapsible - for human habitation.)
Show length at right. Fee = $15
Farm
FRM* Farm Truck used primarily for transporting my farm produce and supplies and NOT for traveling to
and from a non-farm occupation (if 38,000 pounds or more, truck must be used EXCLUSIVELY for
transporting farm produce and supplies.) Fee = Column “E” of fee schedule.
Farm Truck Tractor used EXCLUSIVELY for transporting supplies, farm equipment and products.
Annual Fee = Column “J” of fee schedule.
DPF* Dual Purpose Farm (Farm and non-farm activity) register at gross wt. when used for non-farm occupation.
Farm activity, maximum gross wt. is 12,000 lbs. Fee = Column “A” of fee schedule.
FTL Farm Trailer used exclusively for farm purposes. Fee = Column “F” of fee schedule.
Truck
HTK Truck operated at 8,000 lbs. or more privately or under authority.
Fee = Column “A” of fee schedule.
and/or
LTK* Truck operated at 8,000 lbs. or less privately or under authority. Check Consecutive Monthly
Tractor
DPV* Dual Purpose Truck changes between a truck and motor home.
Registration block if applicable
(Registered at gross wt. when used as a truck)
}
Fee = Column “C” of fee schedule if
DAIRY Motor vehicle transporting Dairy Products EXCLUSIVELY.
truck-tractor, “D” if truck, “F” if trailer.
WOOD Vehicle transporting Raw Forest Products EXCLUSIVELY.
}
Must qualify by Wisconsin Statute
TOR Truck Tractor normally used with semi-trailer. Fee = Column “B” of fee schedule, or if used as road tractor,
column “A” of fee schedule.
Trailer
SEMI Semitrailer used with a Truck Tractor. Fee = $50. for non-expiring, not transferable plates
TRL Trailer registration is optional for private operation 3,000 lbs. or less. Fee = $50.00.
If over 3,000 lbs., registration required. Fee = Column “G” of fee schedule. Trailer for rental or For Hire
must be registered. Check Consecutive Monthly Registration block if applicable
Bus
BUS Bus capacity = 16 or more persons. Fee = Column “A” of fee schedule
BBX Urban Mass Transportation Bus Fee = $5. (5 year plate)
BSB School Bus Fee = $5. (5 year plate) Pre-sale inspection required
GOV
Ocial (Star)
Municipal (Tan)
State Owned (Red)
Fee of $5 for new plate
Plates
Unmarked (choose one):
Auto
Light Truck: Weight lbs.
Cycle
}
issued, $1 for plate transfer.
Special
HSV Human Service Vehicle Fee = $85. Funded by WisDOT transportation assistance
Use
DEV* Driver Education Vehicle Fee = $5. (5 year plate)
SPZ Vehicle owned privately and used exclusively for one of the following. Fee = Column “F” of fee schedule.
Seasonal hauling of carnival rides & equipment
Transporting grading, ditching, or excavating equipment
SUX Special Mobile Equipment – refer to form MV2953 for more information.
SPX Vehicle owned, operated and used exclusively for one of the following. Fee = $5. (5 yr. plate)
Motor Bus for charitable purposes
Motor Bus for parade participants
Other qualifying vehicles
Special A full listing of special plates and applications is available at wisconsindmv.gov/specialplates.
Plates
OTHER Special Plate (Other) - Attach Application
Autocycle
ACY Autocycle fee = $45.00, MAY-APR
Use form MV16 for Autocycle Registration Fee Schedule
MV1-2 5/2021
Section G – MAILED APPLICATIONS ONLY – eNotify Electronic Renewal Notication wisconsindmv.gov/enotify
Sign up to receive your renewal notices electronically! Instructions will be emailed to the address below:
Section H – Consent to Purchase
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 will be used “For Hire”
Authority Number:
MOTORCYCLE/MOPED
manufactured for highway use
and displays required Federal
Certication Label.
NOTE: If this box is not checked, the
entire application will be returned.
RV TRAILER LENGTH:
MOTOR CARRIER CLASS
Include $5 permit fee if operating vehicle
ONLY in Wisconsin. No permit fee is
required for semi-trailers.
Check one:
Private - No permit fees (1)
Rental - Private (5)
Rental - For Hire ... $5 (6)
Rental - Private & For Hire ... $5 (7)
Intrastate (operate inside Wisconsin
only) For Hire, PC or LC ... $5 (8)
Interstate (operate outside Wisconsin)
For Hire (9)
Interstate - Exempt For Hire (3)
Interstate - E
xempt/Intrastate For Hire (4)
NOTE: All For Hire Carriers must show
Authority Number(s) (LC, MC, PC, RC)
Authority Number(s):
Apply for a US DOT Number:
Phone: 1-800-832-5660
Internet: www.safer.fmcsa.dot.gov
CONSECUTIVE MONTHLY REGISTRATION
Used exclusively for one of the following:
• To transport concrete pipe or block and
related materials; calcium chloride liquid;
recycled metal salvage materials; logs or
pulpwood; dirt, ll or aggregates; fresh
milk; perishable fresh fruits or vegetables
for canning, freezing, dehydrating or
storage prior to processing, including
return of waste; petroleum products; or as
a weight transfer machine for purposes
associated with truck or tractor pulling
competitions or events.
• To transport gravel, concrete or cement
and bituminous road construction
materials; or agricultural lime, feed, grain
or fertilizer.
• As a Motor Truck or Truck-Tractor
owned or leased by a retail lumberyard
used exclusively to transport building
construction materials from retail
lumberyards to building construction sites.
• To tow stalled or disabled vehicles.
PASSENGER CAPACITY
Bus School Bus HSV
School Bus approved for registration:
X
(Signature)
(Badge Number) (Date)
Vehicle Owner Certication – If an owner is under 18 years old, complete Consent to Purchase (Section H) above.
I (we) certify that the information and statements on this application are true and correct. Commercial Carrier: I further certify that I have knowledge of applicable federal
and state motor carrier safety rules, regulations, standards, and orders, and declare that all operations will be conducted in compliance with such requirements.
X X
(Owner/Lessee Signature) (Date) (Co-Owner/Lessee Signature) (Date)
*No charge to transfer current license plates. (See Section “B” of Instructions)
Remember to print a copy for yourself.
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form MV2119, Replacement Title Application. Note: The electronic (Bad River Band Of Lake Superior Tribe Of Chippewa Indians)

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Completed 12 November 2021

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