-
ADDITIONAL
OWNER
VEHICLE
SIGNATURES
CERTIFICATIONS
DMV USE ONLY
REMARKS:/&&)#%53%/.,9
INFORMATION
or LESSEE / ADDRESS
INFORMATION
Application for Registration,
Renewal, Replacement
or Transfer of Plates
and/or Stickers
DM V
DEPARTMENT OF TRANSPORTATION
DRIVER AND MOTOR VEHICLE SERVICES
1905 LANA AVE NE, SALEM OREGON 97314
Complete all applicable areas. MAIL TO: DMV, 1905 Lana Ave NE, Salem OR 97314; or take to any DMV office.
VEHICLE IDENTIFICATION NUMBER (VIN)
OREGON TITLE #
1
PRESENT OREGON PLATE #
YEAR
MAKE
STYLE
EQUIPMENT #
WEIGHT / LENGTH
'672
2
SPECIAL PLATES FARM ID # FLEET ACCOUNT #
DIESEL HYBRID
PLUG-IN
GAS
&,%8&5%,
HYBRID
3
NATURAL
ELECTRIC PROPANE
OTHER:
This application cannot be used to change or correct the name(s) shown on the title or to change ownership.
%QORNGVG.KPGYKVJVJGQYPGTYJQUGCFFTGUUYKNNDGWUGFHQTCNN&/8OCKNTGICTFKPIVJKUXGJKENG .KUVCFFKVKQPCNQYPGTUQP.KPGUCPF 6JKUKPPQYC[FGVGTOKPGUCRTKQTKV[QH
QYPGTUJKR+HCP[QYPGTNKUVGFWUGUCPCIGPE[CFFTGUUQP&/8TGEQTFUVJCVQYPGTOWUVDGUJQYPQP.KPG5GGTGXGTUGHQTOQTGKPHQTOCVKQP
PRINT FULL LEGAL NAME: LAST, FIRST, MIDDLE OF (check one)
OWNER OR LESSEE
ODL / ID / CUSTOMER # DATE OF BIRTH
4
RESIDENCE / BUSINESS ADDRESS - (Address will be used to update your ODL / ID Card) MAILING ADDRESS - (If different from residence)
5
CITY, STATE, ZIP CODE
COUNTY OF RESIDENCE CITY, STATE, ZIP CODE COUNTY OF MAILING
6
JOINT OWNER OR LESSEE - PRINT FULL LEGAL NAME: LAST, FIRST, MIDDLE (See “Address Change” on reverse)
ODL / ID / CUSTOMER # DATE OF BIRTH
7
JOINT OWNER OR LESSEE - PRINT FULL LEGAL NAME: LAST, FIRST, MIDDLE (See “Address Change” on reverse)
ODL / ID / CUSTOMER # DATE OF BIRTH
8
ONE-TIME MAILING ADDRESS (For this transaction only – address will not show on your customer record) VEHICLE ADDRESS - (Location of vehicle if different from residence)
9
CITY, STATE, ZIP CODE
CITY, STATE, ZIP CODE COUNTY (of vehicle address or use)
10
By signing this application, I certify:
z to one of the following: 1) If this application includes registration, and this motor vehicle is subject to the financial responsibility laws, I
am in compliance and will remain in compliance until the vehicle is transferred; or 2) if this application includes a registration renewal,
this vehicle is covered by the motor vehicle liability insurance policy listed below.
INSURANCE COMPANY (not agent) POLICY #
11
z My place of domicile (home) is in Oregon or I am otherwise eligible or required to register this vehicle under Oregon law. (ORS 803.200, ORS
803.350, and ORS 803.360).
z If this is initial registration of a tow/recovery vehicle, or initial registration or renewal of a manufactured structure toter, farm, or charitable/non-
profit, the vehicle and its use qualify for special registration and conform to the law.
z All information on this form is true and correct and agree with all applicable statements on the front and back of this form. Under Oregon law, it
is a crime to knowingly make any false statement on an application for registration (ORS 803.375). This offense is a Class A misdemeanor and
is punishable by a jail sentence of up to one year, a fine of up to $6,250, or both.
SIGNATURE OF OWNER AS SHOWN ABOVE DATE
4%,%PHONE #
12
X
SIGNATURE OF JOINT OWNER AS SHOWN ABOVE DATE
4%,%PHONE #
13
X
Passenger Vehicle Plate Type:
14
Transaction Type:
UO DUCKS
REGISTRATION / RENEWAL
REPLACEMENT PLATE(S)
DUPLICATE PLATE(S)*
REPLACEMENT STICKER(S)
REPLACEMENT REG. CARD
CRATER LAKE
POLLINATOR
REMARKS:
735-268 (12-23)
STK# 300111
ONE TWO
*You can get a duplicate of one or both plates assigned to your vehicle if
DMV is currently issuing the design and type. Mark ONE or TWO above.
OTHER:
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*
CUSTOM PLATE:
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*
You must complete and attach a Custom Plate Application, Form 735-205.
WINE COUNTRY
TREE
GRAY WHALE
TRAIL BLAZERS
WILDLIFE
GROUP:
CULTURAL
SALMON
PACIFIC
WONDERLAND
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SMOKEY BEAR
Clear Form
Clear Form
FORM INFORMATION
DMV links all records together based on your customer number. Always use your customer number and the same name
with DMV.
Individual Customer Number: Your customer number is your Oregon driver license (ODL), Identification card (ID) or
instruction permit number if you have one. If you do not have an Oregon customer number, one will be assigned to you.
Business Customer Number: If you know your business customer number, list it on the application.
One-time Mailing Address: Where you want the registration document mailed if different than residence or mailing.
Vehicle Address: Where vehicle is primarily housed or dispatched from if different address than the residence or business.
Address Change: Only the address listed on Line 5 for the owner will be changed if it is different than DMV records.
DMV will update your vehicle and driver record. Additional owners can change their address online at DMV2U.Oregon.gov.
Work Address: If an owner has a work/public agency address on file with DMV and wants that address to be used for the
vehicle record, that person must be listed on Line 4 and the work address listed on Lines 5 and 6.
MILITARY BENEFIT INFORMATION REQUEST
I am a member or veteran of a uniformed service and want DMV to send my name and address to the Oregon Department of Veterans’
Affairs so I can get benefit information.
Name(s):________________________________________________________
DEAF OR HARD OF HEARING NOTATION ON VEHICLE REGISTRATION
□ Add a Deaf/Hard of Hearing note to my registration card, to show that someone driving my vehicle may be deaf or hard of hearing.
NOTES
I certify:
Commercial vehicle: I know the applicable federal motor carrier safety regulations and hazardous materials regulations or compatible
state
regulations.
Registered with truck (T) plates: I have an in-house drug and alcohol testing program that meets the federal requirements; or I am a
member of a consortium that provides testing that meets federal requirements; or I am exempt from the above requirements.
Name of person(s) operating consortium:__________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
COMMERCIAL VEHICLE - DRUG AND ALCOHOL TESTING CERTIFICATION
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
