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Utah State Tax Commission
TC-162 Rev. 1/04

Application For Utah Motor Vehicle Identification Number

Division of Motor Vehicle · 210 North 1950 West · Salt Lake City, Utah 84134 · (801) 297-7780 or 1 800 DMV-UTAH (TDD 297-2020) If you need accommodation under the Americans with Disabilities Act, contact the Tax Commission at (801) 297-3811. or Telecommunications Device for the Deaf (801) 297-2020. Please allow three working days for a response.
Get forms online - tax.utah.gov

Reason for application Altered Other Missing Reconstructed Newly constructed

Vehicle Information VIN on title: VIN on body: Year Make Model VIN on frame: Utah assigned VIN Body type

Affidavit of Construction

Being first duly sworn depose and state that the vehicle described hereon was built, or caused to be built and further swears that all material and labor involved in the construction of said vehicle are paid in full. I further state that the accompanying documents (bill-of-sale, invoice, etc.) are for the "essential parts" used in the construction or reconstruction of this vehicle. The construction was completed _________________________________.
(date)

Warning: Fraudulent application and falsification of documents is a felony under Utah Law. Under penalties of perjury, I declare that to the best of my knowledge and belief, this agreement is true, correct, and complete. I further state that to the best of my knowledge, the vehicle is free and clear of any liens, encumbrances, lawful claims, demands of any person, and that the vehicle is not in any existing or pending litigation. I agree to indemnify the Utah State Tax Commission, and all persons acting under direction of the Tax Commission, from any and all liability and shall defend all litigation which may arise as a result of the issuance of said certificate.
Applicant's name (print) Applicant's address Applicant's signature MV examiner's signature Certificate of VIN Plate Installation Utah vehicle Identification number _______________________________________ has been properly affixed in accordance with the instructions to the _____________________________________________________________________________________ of the vehicle described. MV examiner's signature Date Date signed Date

Requirements For Registering A Homebuilt Trailer/Vehicle 1. Complete the following forms: a. TC-656A MVA, Title and Registration Application b. TC-569A MVA, Ownership Statement c. TC-162, Application for Utah Assigned Identification Number (reverse side) 2. Submit original receipts or copies of original receipts for materials purchased to build vehicle. If no receipts are available, please indicate on the Affidavit of Facts why no receipts are available. 3. Provide a picture of the trailer/vehicle. 4. Take trailer/vehicle to the Motor Vehicle office nearest you for the installation of identification number. 5. Obtain a property tax clearance from the county assessor. 6. Obtain necessary safety inspection/emission test if required. 7. Other

Direct questions to the Motor Vehicle Division nearest you or contact a representative at 1-800-DMV-UTAH.