
TC-656
Page 2
Vehicle Type
Passenger, light truck, van or utility Street motorcycle Snowmobile
Small motor vehicles (CC HP ) Low-speed vehicle Roadable aircraft
Motor home (Length: feet inches) (Class ) Street-legal ATV Manufactured housing
O-highway vehicle (check one: ATV Motorcycle)
Heavy truck (Registered weight: ) 10,001 lbs? Enter your USDOT number:
Trailer (check one: Camper Park model Tent Travel) Utility Other trailer: )
Number of axles: Trailer length: feet inches
Odometer Reading
Odometer (no tenths): Reading is: Miles Kilometers (kilometers will be converted to miles on the title)
I certify that the odometer reading (check one):
Is the actual mileage Is the mileage in excess of odometer’s mechanical limits Is not the actual mileage (Warning: Discrepancy)
Section 4: Registration Information
Note: You may request a personalized plate after we issue the initial plate. Go to mvp.tax.utah.gov. Additional fees will apply.
License plate type:
Title only In God We Trust Life Elevated Arches Life Elevated Skier Transfer: Other:
Address for mailing the license plate (if dierent from street address above) City State ZIP Code
Physical address of vehicle (if dierent from street address above) City State ZIP Code
Contribute $2 to: Friends for Sight Organ Donation Support Contribute $3 to: Emergency Medical/Search & Rescue
Contribute to: Wildlife Crossing Fund
Section 5: Lien Holder Information
Lien holder’s name FEIN (or driver’s license number, if individual) Email address
Mailing address City State Zip Code
Section 6: Owner Signature(s)
I declare that I am the owner of the vehicle described on this application and all the above information is accurate and true. I certify that I
will maintain owner’s or operator’s insurance for this vehicle, as required by law, in order to operate this vehicle on a highway, quasi-public
road, or parking area within Utah.
Owner’s signature Date
Co-owner’s signature Date
Section 7: Purchase and Dealer Information (For Utah Dealership Use Only)
The vehicle title is: Paper title E-title
I certify that the vehicle is accurately described on this application and has been delivered to the buyer named above and that this dealer-
ship is in compliance with the licensing requirements in Utah Code, T
itle 41, Chapter 3, Part 2. I also certify that this transaction complied
with the sales tax reporting requirements in UCA §59-12-107.
Purchase date Dealer number Permit number Permit issue date
Dealer/authorized representative’s signature Signature date
To review the Privacy Notice regarding the collection and use of your personal data, see tax.utah.gov/privacy
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New Used