Vehicle/Queensland Regulated Ship Cancellation
of Registration Application
Postal address (if same as above write ‘as above’)
If you are cancelling a vehicle, dealer plate or trailer trade plate go to section 2
If you are cancelling a ship, go to section 3
Vehicle Identication Number/Chassis number
Was the vehicle assessed by an insurer? (Vehicle only)
If the vehicle is less than 16 years old, complete Written-o Vehicle Notication -
Individual (Form F4069) to determine if the vehicle is to be recorded on the written-o
vehicle register. Complete sections 6 (if applicable) and 7.
Cancellation date for a vehicle may be backdated to the day after the accident or event only if:
• Documentation from an ocial source (for example, Insurer or Police) is provided conrming the date of the accident or event; and
• Section 7 is completed, conrming that the vehicle has not been used on a road since the accident or event; and
• Written-o Vehicle Notication - Individual (form F4069) has been completed (only if the vehicle has not been assessed by an insurer).
Cancellation date for a ship is taken only on the day of the submission of the form.
Ship registration numbers
It will be necessary to ensure that the ship registration numbers are removed and that the following declaration is completed.
I/We declare that the registration numbers have been removed from the hull.
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1. Registered operators details
Transport Operations (Road Use Management) Act 1995, Transport Operations (Marine Safety) Act 1994
2. Vehicle details
Vehicle make/model (for example, Ford Falcon)Registration number
Go to section 4
3. Ship details
Registration number Ship manufacturer Engine number/s
Signature of person who removed the registration number Date
Accident or event (e.g. ood, re)
• Number plates: Number plates must be surrendered upon cancellation except if you are cancelling due to COVID-19. If you are cancelling
due to COVID-19 and you intend to re-register your vehicle at a later date, you should remove your number plates from the vehicle and
securely store them to be reattached when you re-register. The Department of Transport and Main Roads will customise your number plates
free of charge to facilitate this process. If you do not intend to re-register your vehicle, you should securely dispose of your number plates. If
you do not dispose of your plates securely and they are reattached to a vehicle, any camera-detected oences or toll infringements will
be sent to you as the last registered operator.
• Number plate conscation notice: A vehicle currently under a Number Plate Conscation Notice issued by the Queensland Police Service,
cannot be cancelled during the conscation period. Please contact the Queensland Police Service prior to lodging your application.
• Lodging your application: You can lodge your completed form by email to firstname.lastname@example.org or mail to Department of
Transport and Main Roads, Vehicle Cancellations, PO Box 372, LONGREACH QLD 4730. If you intend to cancel the registration of more
than 5 vehicles, complete this form once for the rst vehicle and send an attachment with all of the vehicle details as outlined in Question 2
to email@example.com. Please ensure your postal address provided to TMR is up to date prior to lodging your application as
all cancellations requested by email will be refunded by cheque. You must not use the vehicle after you have lodged your application for
cancellation. There are signicant nes for driving an unregistered vehicle.
• Direct Debit: If this vehicle is enrolled for Direct Debit, it is your responsibility to ensure the vehicle/ship is removed from the scheme prior
to the cancellation of registration.
Registered operator request
Vehicle re-registered in Queensland/Interstate
4. Reason for vehicle/ship cancellation
Claim number (if known)
Email address Mobile/Telephone number
Go to section 4
For vehicles - Complete sections 6 (if applicable) and 7.
Ship was stolen
Complete section 7.
Vehicle was stolen
Complete sections 5, 6 (if applicable) and 7.
TRB Forms Area F3517 V01 Jul 2021
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