NAME OF PERSON SUBMITTING DOCUMENTS TO DMV
PRINTED NAME:
SIGNATURE:
LICENSE #: LICENSE STATE:
TRANSACTION TYPE (PLEASE SELECT ONE)
UPDATE CURRENT INFORMATION
(complete sections A,B*,D,E,G)
PLATE #: _______________
SURVIVING SPOUSE
(complete sections A,D,E,F,G)
PLATE #: _______________
RENEWAL
(complete sections A,B*,D,E,G)
PLATE #: _______________
LAST NAME (OR COMPANY NAME):
FIRST NAME:
MIDDLE INITIAL:
SUFFIX:
STREET ADDRESS:
APT./FLOOR:
RESIDENCE (WHERE VEHICLE IS KEPT OR GARAGED)
CITY / STATE / ZIP CODE:
STREET ADDRESS: APT./FLOOR:
MAILING (IF ADDRESS IS DIFFERENT THAN RESIDENCE)
CITY / STATE / ZIP CODE:
LICENSE #: DATE OF BIRTH:
B*. LESSEE’S INFORMATION (IF VEHICLE IS LEASED)
NEW REGISTRATION
(complete sections A,B*,C,D,E,F,G)
PLATE #: _______________
TRANSFER REGISTRATION
(complete sections A,B*,C,D,E,F,G)
PLATE #: _______________
DUPLICATE REGISTRATION
(complete sections A,B*,D,E,G)
PLATE #: _______________
PLATE CHANGE
(complete sections A,B*,D,E,G)
PLATE #: _______________
LAST NAME (OR COMPANY NAME):
FIRST NAME:
MIDDLE INITIAL:
SUFFIX:
LICENSE #: DATE OF BIRTH::
C. SELLER’S INFORMATION
SELLER’S NAME:
STREET ADDRESS:
APT./FLOOR:
CITY/STATE/ZIP CODE:
DATE OF SALE: RI DEALER’S LICENSE #:
D. INSURANCE INFORMATION
LIABILITY INSURANCE COMPANY NAME:
POLICY #:
EFFECTIVE DATES (FROM and TO):
PLATE
PLATE DESIGN
TRANSACTION #
TAX
FOR OFFICIAL USE ONLY
E. VEHICLE INFORMATION (ALL FIELDS ARE MANDATORY)
F. LIEN INFORMATION (COMPLETE IF THERE’S A VEHICLE LOAN)
*PLEASE CHECK THIS BOX IF THERE IS NO LIEN*
(1) LIENHOLDER NAME:
STREET ADDRESS:
CITY / STATE / ZIP CODE:
DATE OF LIEN:
G. SIGNATURE
I, THE UNDERSIGNED, HEREBY MAKE APPLICATION TO
REGISTER THE ABOVE DESCRIBED VEHICLE AND AS PART OF
MY APPLICATION DECLARE UNDER PENALTY OF PERJURY
THAT I AM THE OWNER OR THE LESSEE, THAT NO OTHER
LIENS EXIST AGAINST THE VEHICLE EXCEPT AS DESCRIBED
HEREIN, AND THAT ALL STATEMENTS MADE ON THIS
APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY
KNOWLEDGE AND BELIEF. I ALSO CERTIFY UNDER PENALTY
OF PERJURY THAT I HAVE READ, UNDERSTAND, AND WILL
FOLLOW THE CONDITIONS CONTAINED IN THE INSURANCE
COMPLIANCE STATEMENT ON THE REVERSE SIDE OF THIS
FORM.
TOTAL
CHECK CASH
YEAR: VIN (VEHICLE IDENTIFICATION #):
MAKE: MODEL: BODY TYPE: GROSS VEHICLE WEIGHT:
COLOR: # OF CYLINDERS: CURRENT MILEAGE:
DOES VEHICLE HAVE A PICKUP BED? CAMPERS AND TRAILERS ONLY
YES NO
NUMBER OF SEAT BELTS IN
VEHICLE: _________
FUEL TYPE (CHECK ONLY ONE):
GAS
HYBRID
ELECTRIC
DIESEL CNG/LPG
LENGTH: ______ CARRYING CAP.: ______
MOTORCYCLES/MOPEDS/SCOOTERS ONLY
YES NO
ENGINE SIZE/CC/MPH: ______ MAX SPEED.: ______
PEDALS?
(2) LIENHOLDER NAME:
STREET ADDRESS:
CITY / STATE / ZIP CODE:
DATE OF LIEN:
EXCEPT AS AUTHORIZED BY LAW, THE DMV WILL NOT
DISCLOSE PERSONAL INFORMATION WITHOUT YOUR
CONSENT.
DO YOU CONSENT TO SUCH DISCLOSURE?
OWNER’S SIGNATURE:
DATE:
SECOND OWNER’S SIGNATURE:
IF CORPORATION, GIVE TITLE OR POSITION:
IF MINOR, SIGNATURE OF PARENT OR GUARDIAN:
NOTARY PUBLIC SIGNATURE:
NOTARY PUBLIC NAME:
DATE:
COMMISSION EXPIRATION DATE (MANDATORY):
APPLICATION FOR REGISTRATION
AND TITLE CERTIFICATE (TR-1)
STATE OF RHODE ISLAND – DIVISION OF MOTOR VEHICLES
600 New London Avenue, Cranston, RI 02920-3024 Phone: 401-462-4368 www.dmv.ri.gov
rev.6/21
OWNER’S SIGNATURE MUST BE NOTARIZED IF NOT PRESENT DURING TRANSACTION
NOTARY STAMP MUST BE INK AND NOT ONLY EMBOSSED
PHONE #:
CC
A. REGISTRANT – BUYER, LEASING COMPANY OR NEW OWNER
SECOND OWNER INFORMATION, IF APPLICABLE
TAX & TITLE
(complete sections A,B*,C,E,F,G)
YES NO
LAST NAME: PHONE #:
FIRST NAME:
EMAIL ADDRESS:
TAX TOWN:
LICENSE #: DATE OF BIRTH::
STREET ADDRESS:
APT./FLOOR:
RESIDENCE (WHERE VEHICLE IS KEPT OR GARAGED)
CITY / STATE / ZIP CODE:
EMAIL ADDRESS:
TAX TOWN:
TYPE