Type of Plate: Enter type of plate ex: Auto, Truck, Commercial etc.
Dealer Code: Please insert dealer code in bold letters if applicable.
Vehicle Identification Number: Serial number of vehicle.
Make: Enter name of manufactured vehicle.
Louisiana License Plate Number: If applicable. (used vehicle)
Body: Enter appropriate body style. Ex. (PK, 4DR, 2DR, etc.)
Color: Enter appropriate basic color.
Year: Enter complete model year. (Example: 1997)
Mileage: Enter mileage reading on vehicle at time of sale. DO NOT SHOW TENTHS and do not estimate.
Driver's License: Enter owner's driver's license number.
Model/Weight: Model of vehicle or weight if a truck.
EIN Number: Enter corporations or company Employer's Identification Number (EIN).
Owner's Name: Enter first and last name of applicant. Middle initial if applicable.
Street: Enter physical address of applicant. A P.O. Box will not work unless it is a rural area.
Domicile Code: Taken from tax chart.
Indicate inside or outside of city limits.
City/Parish/State: Enter name of city, parish, state and zip code.
Check one (1) of the following boxes:Lessee/Mail-To/Operator/Domicile Name.
Lessee/Mail-To/Operator/Domicile Street Address.
Lessee/Mail-To/Operator/Domicile City/Parish/State.
License Plate Number of Trade: Enter license plate number of vehicle.
Vehicle Identification Number of Trade: Enter (VIN).
Lien Information: Enter name, street and/or post office box number and zip code of Lien Holder if applicable.
Amount: Not applicable.
Date: Date stamped by department.
Second Lien Information: If applicable.
New/Used/Date Acquired: Check appropriate box and enter purchase date.
Tax Date: Enter date of purchase.
State Fees: See chart.
Sales Tax: Enter Appropriate Sales Tax.
Penalty & Interest: Customer has 40 days from date of sale to register a vehicle without penalty or interest. After the 40 days, penalty is computed at 5% of the sales tax per month up to 5 months maximum. The interest is computed at 1.25% of the sales tax per month with no maximum.
Cost of Vehicle: Enter gross sale price.
Less Trade: Enter amount allowed for trade.
Rebate: Enter amount of rebate if applicable.
Tax Value: Enter net sales price. Gross cost of vehicle less trade-in and rebate.
Insurance Declaration: Check appropriate box and applicant's signature required declaring liability insurance.
Duplicate Title: Check appropriate box, signature of applicant must be witnessed and notarized. If there was a lien, a notarized affidavit of satisfaction from the lien holder is needed. If a POA is used to sign the application, a copy of the driver's license of the POA is needed.
Non-possession of Title by lien holder: Check appropriate box, registered owner's signature must be witnessed and notarized, signature of lien holder must be notarized.
"A" Conversion: To convert from one type of plate to another.
"B" Transfer Of Plate: To transfer an existing plate to a different vehicle.
"C" Lost Or Stolen Plate: To replace a lost or stolen plate/sticker.
"D" Title Correction: To correct wrong information on a title (must be submitted along with original title).
"E" Farm Use Affidavit: To be used in order to obtain a farm plate.
"F" Bill Of Sale: May be used for individuals only.
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