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Blank Louisiana Vehicle Application Form

The Louisiana Vehicle Application form is a crucial document required for registering vehicles in the state of Louisiana. This form facilitates the collection of essential information regarding vehicle ownership, lienholders, and insurance compliance. Proper completion of the application ensures a smooth registration process and helps avoid potential delays or rejections.

Outline

The Louisiana Vehicle Application form is a crucial document for anyone looking to register a vehicle in the state. This form captures essential details such as the vehicle's make, model, and VIN, ensuring that all necessary information is accurately recorded. Applicants must provide their name, address, and driver's license number, along with any joint owners if applicable. The form also addresses important aspects like lienholder information, which is vital for those financing their vehicles. Additionally, it includes sections for individuals declaring their vehicle's use, whether for personal or commercial purposes. For those needing a duplicate title, a notarized affidavit is required to confirm the original was lost or never received. It’s also important to note that proof of liability insurance must be submitted to process the application. Timeliness is key; applicants must file within specific deadlines to avoid penalties. Overall, understanding the components of this form can streamline the registration process and help ensure compliance with state regulations.

Sample - Louisiana Vehicle Application Form

Louisiana Department of Public Safety and Corrections

TO AVOID REJECTION:

Office of Motor Vehicles

Complete all required information

P.O. Box 64886, Baton Rouge, LA 70896-4886

TRANSFER CODE

ELECTRONIC FUND

Date Prepared

Type of Plate

VEHICLE APPLICATION

DEALER CODE

VIN

Make

License No.

Exp. Date

Body

Color

Year

Mileage

Model/Weight

Name of Owner

Driver's License or EIN

Name of Joint Owner (if applicable)

Driver's License or EIN

Owner's Principal Residence Address (or Business Location if Vehicle is Used for Commercial Purposes)

Are you

residing within the corporate limits of municipality?

YES

City

Parish

State/Zip

Are you residing within a special tax district or ward?

YES

If yes, what ward or district?

Lessee

Mail To

Domicile

Renter

If lessee, domicile, or renter is indicated, renewal notice

should be mailed to (check one):

Domicile Code

Owner

Lessee, renter, or domicile address

Name

Driver's License or EIN of Lessee or Renter

Street

Trade VIN

City

Parish

State/Zip

Trade License No.

VEHICLE IS SUBJECT TO SECURITY AGREEMENT AS FOLLOWS:

ELECTRONIC LIEN

First Lienholder's Name

Second Lienholder's Name

TRANSFER CODE

Street

City/State/Zip

New

Date Acquired

Tax Date

Previous Title No.

State

Cost of Vehicle

Less Trade

Used

Title Fee

Lic Pen Credit

Handling Fee

Rebate

Tax Value

Mortgage Fee

Tax

Tow Fee

DUPLICATE TITLE AFFIDAVIT (Must be signed by owner and notarized.)

The certificate of title issued to me was

License Fee

*Tax Penalty

Miscellaneous Fee

. lost

mutilated

never received

Lic Transfer Fee

*Interest

Total Fees

I make application for a duplicate copy of said certificate and agree to hold the

License Credit

Vendor's Comp

Total Taxes

Commissioner harmless if the previous title is obtained by another person.

I give the Commissioner permission to mail the title to the address on this

License Penalty

Tax Credit

Grand Total

application.

BE SURE TO SIGN AND DATE

I do swear or affirm that the information contained in this document is true and

Owner(s)'s Signature(s) for Duplicate Title

correct to the best of my knowledge.

I have and will maintain, during this registration period, vehicle liability insurance

Witness

(security) required by LRS Title 32:861-865. Failure to maintain as agreed will

Sworn and subscribed before me this ________ day of ____________, _______

be a violation of law which may result in criminal prosecution and/or suspension

of registration privileges.

Notary Public Signature, Printed Name

ID Number

If the vehicle being registered is defined as a commercial motor vehicle by the

AFFIDAVIT OF NON-POSSESSION OF TITLE BY LIENHOLDER.

Federal Motor Carrier Safety Regulations and/or Federal Hazardous Material

Regulations, by signature below registrant declares knowledge of those federal

Must be signed by lienholder and notarized.

regulations.

I hereby swear or affirm that title of above described vehicle showing lien in our

favor was

never received

received and surrendered to the owner.

Applicant's Signature

Date

Co-Applicant's Signature

Date

Lienholder's Signature

PROOF OF LIABILITY INSURANCE MUST BE FURNISHED AS

PROVIDED FOR BY LAW BEFORE THIS FILE CAN BE PROCESSED.

Witness

TO AVOID PENALTY AND INTEREST:

Sworn and subscribed before me this ________ day of ____________, _______

File must be submitted within 40 days from the date of purchase. For

manufactured houses (mobile homes), file must be submitted by the 20th of the

month following the month of delivery.

Notary Public Signature, Printed Name

ID Number

*Tax Penalty: 5% of sales tax due for 30 days or fraction thereof (not to

RECEIVED/REJECTION DATE(S)

exceed 25%).

*Interest: 1.25% of sales tax due for 30 days or fraction thereof

(no maximum).

NOTICE:

If a title, license plate, or validation sticker is not received within thirty (30) days after submitting application and fees for such, contact your nearest Office of Motor Vehicles. Departmental policy provides for the issuance of a free replacement within sixty (60) days from the date of issuance. Failure to notify this office timely could result in additional fees being charged.

A.	CONVERSION
	Old License Plate Number _____________________	New License Plate Number _____________________
	Use _____________________	Use _____________________
	Weight _____________________	Weight _____________________

B.TRANSFER OF PLATE

License plate ___________________ has been removed from a _______________________________________________________

YEAR MAKE VIN

and transferred to the vehicle described on the first page of this form. License plate returned is ______________________________

C. LOST, STOLEN, OR REPLACEMENT

PLATE

STICKER

License Plate Number ________________

D.TITLE CORRECTION

Error: _____________________________________________________________________________________________________

__________________________________________________________________________________________________________

Correct To: ________________________________________________________________________________________________

__________________________________________________________________________________________________________

E.FARM USE STATEMENT

I do declare that I am a bona fide farmer and am in the business of farming; that the vehicle described on the first page of this form is used primarily, but not exclusively, in hauling farm produce raised on my farm, from such farm to market and return therefrom; hauling merchandise to my farm and that this vehicle will not be used to haul another person's farm produce or other products for a fee or compensation. Said farm is located at:

________________________________________________________________________________________________________________

RFDBoxCityParishZip

________________________________________________________________________________________________________________

Owner's Signature

F.OUT OF STATE DECLARATION


I,		declare that the
	(Printed name of owner)		MAKE	MODEL	VIN
was domiciled in Louisiana on			.

G.DISCLOSURE OF SALVAGE / RECONSTRUCTED / WATER DAMAGED / HAIL-DAMAGED

I,	swear under penalties of perjury that:

(Printed name of owner)

the title covering the vehicle,

MAKEMODEL

Louisiana R.S. 32:706.1, has been branded:

VIN

Salvaged Vehicle

,in accordance with

Reconstructed Vehicle

In accordance with Louisiana R.S. 32:789, the undersigned confirm that the above referenced vehicle has sustained water damage to the following extent:

In accordance with Louisiana R.S. 32:781, the undersigned confirm that the above referenced vehicle has sustained water damage

to the following components: Power Train

Computer

Electrical System

In accordance with Louisiana R.S. 32:702(13), the undersigned confirm that the above referenced vehicle has sustained only cosmetic damage caused by hail, equivalent to seventy-five percent or more of its market value as a result of costs or repairs to items such as windshield, windows, and rear glass; exterior paint and paint materials; and body damage such as dents.

Hail-Damaged

Signed by

under penalties of perjury this day of

(Signature of vehicle owner)

, 20

False statements are punishable by fine, imprisonment or both under R.S. 32:730.

Click for PDF

Form Information

Fact Name	Details
Governing Law	The Louisiana Vehicle Application form is governed by Louisiana Revised Statutes Title 32:861-865.
Required Information	All required fields must be completed to avoid rejection of the application.
Submission Deadline	Applications must be submitted within 40 days from the date of purchase to avoid penalties.
Proof of Insurance	Proof of liability insurance is required before the application can be processed.

Detailed Guide for Filling Out Louisiana Vehicle Application

Filling out the Louisiana Vehicle Application form is a straightforward process. It is essential to complete all required information accurately to avoid any delays in processing your application. Once the form is filled out, it should be submitted to the appropriate office for further action.

Obtain the Louisiana Vehicle Application form from the Louisiana Department of Public Safety and Corrections or their website.
Fill in the Date Prepared section with the current date.
Indicate the Type of Plate you are applying for.
Enter the VIN (Vehicle Identification Number) of the vehicle.
Provide the Make, Model, and Year of the vehicle.
Fill in the Body Color of the vehicle.
Input the License No. and Expiration Date if applicable.
Enter the Mileage of the vehicle.
Provide the Name of Owner and their Driver's License or EIN.
If applicable, include the Name of Joint Owner along with their Driver's License or EIN.
Fill in the Owner's Principal Residence Address or Business Location if the vehicle is used for commercial purposes.
Answer the questions regarding residency within the municipality and special tax district by marking YES or NO.
If you are a lessee, renter, or domicile, indicate where the renewal notice should be mailed.
Fill out the First Lienholder's Name and Second Lienholder's Name if applicable.
Complete the New Date Acquired and Tax Date sections.
List any fees and taxes in the appropriate sections, including the Total Fees.
If applying for a duplicate title, sign and date the Duplicate Title Affidavit section.
Provide proof of liability insurance as required by law.
Sign and date the application, ensuring all information is accurate.
Submit the completed form to the designated office.

Obtain Answers on Louisiana Vehicle Application

What is the Louisiana Vehicle Application form?
The Louisiana Vehicle Application form is a document used to register a vehicle in the state of Louisiana. It collects essential information about the vehicle, the owner, and any liens on the vehicle. Proper completion of this form is crucial for obtaining a title and license plate.
Who needs to fill out this form?
Any individual or business that wishes to register a vehicle in Louisiana must complete this form. This includes new vehicle owners, those transferring ownership, and individuals applying for a duplicate title. If the vehicle is used for commercial purposes, additional information may be required.
What information is required on the form?
The form requires various details, including:
- Vehicle Identification Number (VIN)
- Make, model, year, and color of the vehicle
- Owner's name and address
- Driver's license number or Employer Identification Number (EIN)
- Liens on the vehicle, if any
- Proof of liability insurance
What happens if I don’t submit the form on time?
It is essential to submit the application within 40 days from the date of purchase to avoid penalties and interest. For manufactured homes, the deadline is the 20th of the month following delivery. Late submissions may incur additional fees.
Is proof of insurance necessary?
Yes, proof of liability insurance must be provided before the application can be processed. This requirement is in place to ensure that all vehicles on the road are adequately insured.
What should I do if my title or license plate is not received?
If you do not receive your title, license plate, or validation sticker within 30 days of submitting your application, it is important to contact your nearest Office of Motor Vehicles. The department policy allows for a free replacement within 60 days of issuance.
Can I apply for a duplicate title?
Yes, if your original title has been lost, mutilated, or never received, you can apply for a duplicate title. This application must be signed by the owner and notarized.
What if there are errors on my application?
If you notice any errors on your application, you can submit a title correction request. This correction must be clearly stated on the form, specifying the error and the correct information.
Are there any specific declarations I need to make?
Yes, if your vehicle has been salvaged, reconstructed, or has sustained water damage, you must disclose this information on the form. Failure to do so can result in penalties.

Common mistakes

Filling out the Louisiana Vehicle Application form can be straightforward, but many people make common mistakes that can lead to rejection. One frequent error is failing to complete all required information. Each section of the form must be filled out accurately. Leaving any fields blank can delay the processing of your application.

Another mistake is not providing the correct Vehicle Identification Number (VIN). The VIN is unique to each vehicle and must match the one on the title. Double-checking this number can prevent unnecessary complications.

Many applicants also forget to include their proof of liability insurance. This is mandatory before the application can be processed. If you do not provide this documentation, your application will be held up.

People sometimes overlook the signature requirement. Both the owner and any co-applicants must sign the form. Missing signatures can lead to immediate rejection, so be sure to check this detail before submitting.

Inaccurate addresses are another common issue. Ensure that the owner’s principal residence address is correct and complete. An incorrect address can cause problems with receiving your license plate or title.

Some individuals fail to submit the application within the required time frame. The form must be submitted within 40 days from the date of purchase. Missing this deadline can result in penalties, so be mindful of the timeline.

Lastly, many applicants do not read the instructions carefully. Each section of the form has specific requirements. Taking the time to read through the guidelines can save you from making mistakes that could delay your application.

Documents used along the form

When applying for vehicle registration in Louisiana, the Vehicle Application form is just one of several important documents that may be required. Each of these forms serves a specific purpose and helps ensure that the registration process is completed smoothly and in compliance with state regulations. Below is a list of commonly used forms that accompany the Louisiana Vehicle Application form.

Duplicate Title Affidavit: This document is necessary when the original title has been lost, damaged, or never received. The owner must sign and notarize this affidavit to request a duplicate title.
Affidavit of Non-Possession of Title by Lienholder: If a lienholder claims that they never received the title for a vehicle, they must complete this affidavit, which also requires notarization, to confirm their position.
Proof of Liability Insurance: Before the application can be processed, proof of valid vehicle liability insurance must be submitted as mandated by law. This document verifies that the vehicle owner has the required coverage.
Farm Use Statement: For individuals using a vehicle primarily for farming purposes, this statement declares that the vehicle is used to transport farm produce and will not be used for commercial hauling of others' goods.
Out of State Declaration: This declaration is used by individuals who are registering a vehicle that was previously domiciled in another state. It provides essential information regarding the vehicle's history.
Disclosure of Salvage/Reconstructed/Water Damaged/Hail-Damaged: This disclosure is crucial for vehicles that have been salvaged or have sustained significant damage. It requires the owner to confirm the extent of the damage and is subject to penalties for false statements.
Title Correction Form: If there are any errors on the title that need to be corrected, this form is used to specify the mistake and provide the correct information.
Electronic Lien Notification: This document is used to inform the state that a lien has been placed on the vehicle electronically. It helps maintain accurate records of ownership and financial obligations.
Transfer of Plate Form: When a license plate is being transferred from one vehicle to another, this form details the old and new license plate numbers and the vehicles involved in the transfer.

Each of these documents plays a vital role in the vehicle registration process in Louisiana. Ensuring that all necessary forms are completed accurately and submitted in a timely manner can help prevent delays and complications. It is essential for vehicle owners to be aware of these requirements to facilitate a smooth registration experience.

Similar forms

Vehicle Registration Application: Similar to the Louisiana Vehicle Application form, this document is used to register a vehicle with the state. It requires information about the vehicle, the owner, and proof of insurance, ensuring compliance with state regulations.
Title Application: This document is used when applying for a title for a vehicle. Like the Louisiana Vehicle Application, it collects details about the vehicle and the owner, and may also require information about any liens on the vehicle.
Duplicate Title Request: If a vehicle title is lost or damaged, this document allows the owner to request a replacement. It shares similarities with the Louisiana form in that it requires notarization and a sworn statement regarding the title's status.
Bill of Sale: This document serves as proof of purchase when buying or selling a vehicle. It includes details about the vehicle and parties involved, much like the Louisiana Vehicle Application, which also requires information about the vehicle and its ownership.
Affidavit of Non-Possession of Title: Used when a lienholder cannot provide the title, this document confirms the lienholder's claim. It mirrors the Louisiana Vehicle Application in that it requires signatures and notarization to verify the information provided.

Dos and Don'ts

When filling out the Louisiana Vehicle Application form, it is important to follow specific guidelines to ensure a smooth process. Here are nine things to keep in mind:

Do complete all required information accurately.
Do provide your driver's license number or EIN for both the owner and any joint owners.
Do indicate whether you reside within a municipality or a special tax district.
Do sign and date the application to validate it.
Do ensure proof of liability insurance is attached before submission.
Don't leave any sections blank; incomplete forms may be rejected.
Don't submit the application after the 40-day window from the purchase date.
Don't forget to include any applicable fees to avoid penalties.
Don't ignore the requirement for notarization where indicated.

By adhering to these guidelines, applicants can reduce the likelihood of delays or complications in the processing of their vehicle application.

Misconceptions

Misconceptions about the Louisiana Vehicle Application form can lead to confusion and delays in processing. Here are five common misunderstandings:

All information is optional. Many believe that they can skip sections of the application. However, every required field must be completed to avoid rejection. Incomplete applications will delay the registration process.
Proof of insurance is not necessary. Some applicants think they can submit the form without showing proof of liability insurance. In reality, this documentation is mandatory before the application can be processed.
There is no deadline for submission. A common misconception is that applicants can take their time submitting the application. In fact, the application must be filed within 40 days from the date of purchase to avoid penalties and interest.
Only the owner needs to sign the application. Some believe that only the primary owner's signature is required. However, if there is a joint owner or a lienholder, their signatures are also necessary for the application to be valid.
Duplicate titles can be obtained easily without notarization. Many think that requesting a duplicate title is a simple process. In truth, the duplicate title affidavit must be signed by the owner and notarized, adding an extra step to the process.

Understanding these misconceptions can help ensure a smoother experience when filling out the Louisiana Vehicle Application form. It is always best to read the instructions carefully and provide all necessary information to avoid any potential issues.

Key takeaways

When filling out the Louisiana Vehicle Application form, there are several important points to keep in mind to ensure a smooth process. Here are some key takeaways:

Complete All Required Information: Make sure to fill in every mandatory field accurately. Incomplete applications can lead to delays or outright rejection.
Submit Timely: It is crucial to file the application within 40 days from the date of purchase to avoid penalties and interest. For manufactured homes, the deadline is the 20th of the month following delivery.
Proof of Insurance: Before the application can be processed, you must provide proof of liability insurance as required by law. Ensure this documentation is included with your submission.
Check for Missing Titles: If you do not receive your title, license plate, or validation sticker within 30 days after submission, contact your local Office of Motor Vehicles. Prompt action can help avoid additional fees.