Dealer application for transfer of registration

This form must be completed and signed by both the seller and buyer and returned to VicRoads within 10 days of delivery. For correct processing, please print clearly in ink using BLOCK letters. All details should be provided including the licence number for all Victorian licence holders. VicRoads’ vehicle register is not a register of title (vehicle ownership).

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THIS ORIGINAL MUST BE SUBMITTED TO VICROADS

Seller detailsSurname OR company name/Dealer name

Given name(s) OR ACN (if applicable)

Victorian licence / client no. / LMCT no. Date of birth

Home (or company) address

Postcode

Postal address (if different from above)

Postcode

Phone Email (optional)

Vehicle detailsSerial number Registration number

Year Make

Model Body type

VIN (chassis, frame or engine number if no VIN)

Is this vehicle recorded on the Victorian or interstate written-off vehicles register?

Yes Further information about written-off vehicles is available at VicRoads’ website.

No

RWC serial number RWC issue date

RWC tester’s licence number

EX

By signing this form, I declare that all information and/or documents provided by me is true and correct and I understand the Privacy statement. I acknowledge that a copy of this form may be provided by VicRoads to the buyer (acquirer) upon request. I have informed the buyer that this vehicle is recorded on the Victorian or an interstate written-off vehicles register (if applicable). I agree with the buyer on the market value of the vehicle as declared on this form. I declare that this vehicle is registered at the date of sale and acknowledge that any remaining period of registration of this vehicle is transferred to the buyer.

Signature of seller

Date

Given name(s) OR ACN (if applicable)

Victorian licence / client no. / LMCT no. Date of birth

Is the buying customer a:

Victorian driver licence holder Interstate driver licence holder moving to Victoria Overseas visitor staying in Victoria for more than six months Overseas visitor staying in Victoria for less than six months

Home (or company) address

Postcod

Garaged address (if different from above)

Postcode

Postal address (if different from above)

Postcode

Phone Email (optional)

Transfer details Market value of the vehicle

To avoid penalties do not under declare the market value.

Date of delivery

To avoid liability for traffic offences and penalties the exact date of delivery must be shown.

PaymentTransfer fee

+

Motor vehicle duty (if buyer is private)

= Total payable

By signing this form, I declare that all information and/or documents provided by me is true and correct and I understand the Privacy statement. I acknowledge that a copy of this form may be provided by VicRoads to the seller (disposer) upon request. I have checked the vehicle details provided by the seller match the vehicle and agree on the market value of the vehicle as declared on this form.

Signature of buyer

Date

Privacy statementProviding false and/or misleading information or documents is a serious offence under the Road Safety Act 1986 and/or Marine Safety Act 2010 and can result in you being fined or imprisoned. Any authority or approval, given as a result of you providing such information/documents, may be reversed and have no effect.Personal information VicRoads collects from you may be used for the purposes, and disclosed to persons, permitted by Section 92 of the Road Safety Act, and the Marine Safety Act 2010. It may be disclosed to various organisations and persons, including (without limitation) to contractors and agents of VicRoads, law enforcement agencies, other road and traffic authorities, the Transport Accident Commission, vehicle manufacturers (for safety recalls), road safety researchers, courts and other organisations or people authorised to collect it.

You are required to provide this personal information. Failure to provide the information may result in this form not being processed, or records not being properly maintained. For further information about our use of your personal information and your right of access to it, see the VicRoads brochure “Protecting your Privacy”, or contact VicRoads on 13 11 71.

Customer instructions (non dealer)–Read before signing: Ensure that the dealer completes all the details of the transfer including the date of delivery and has

informed you if the vehicle was recorded on the written-off vehicles register. Refer to the VicRoads website for more information.

If you are buying the vehicle from a dealer, ensure that the dealer declared the vehicle market value and has obtained and specified the number of a Certificate of Roadworthiness (RWC) issued in Victoria not more than 30 days before the date of delivery.

Ensure that you provide your customer details as follows:■ All the questionnaires have been appropriately ticked and answers provided.■ The name on the form matches that of your driver’s licence. Company names must be as registered

with the Australian Securities and Investments Commission (ASIC). A trading name or an Australian Business Number (ABN) must not be used to register a vehicle.

■ Full particulars have been provided. Temporary overseas visitors are to provide mobile phone and email address to ensure that they can be contacted by VicRoads whilst in Australia should any issues arise surrounding the registration transfer.

■ If all the details are correct, please read the privacy statement, then sign and date the form. Private buyers must pay the motor vehicle duty and the transfer fee to the dealer. Private sellers will not

have to pay these fees. Keep the customer copy of the completed form. The dealer will submit the original form to VicRoads on your

behalf. For private buyers, the dealer will also submit the RWC and your paid fees to VicRoads.If you are the buyer, you will receive confirmation by mail within 28 days if your transfer is processed successfully. If no confirmation has been received, contact VicRoads on 13 11 71.