CA REG 5103 2014-2025 free printable template

PRiNt tRuE full NamE siGNatuRE x mailiNG addREss note Vehicles located in the following cities are ineligible for the exemption. Nevada carson city centerville crystal bay Gardnerville Genoa Glenbrook incline Village minden REG 5103 NEW 4/2014 WWW Reno sparks stateline stewart Washoe city Verdi Zephyr cove Mexico tecate tijuana tijuana baja ca Print Clear Form. STATE OF CALIFORNIA DEPARTMENT OF MOTOR VEHICLES A Public Service Agency ApplicAtion for temporAry SmoG exemption for A Vehicle locAted...out-of-StAte h Sc 44011 cVc 20 1653 8800 Your vehicle may qualify for temporary exemption from biennial smog requirements if it is temporarily located out of state. You must provide the following information in order to determine eligibility for the exemption* Section 1 Vehicle informAtion VEhiclE idENtificatioN NumbER as of datE YEaR makE modEl VEhiclE licENsE NumbER the vehicle has been located outside of california and is currently physically located/garaged at stREEt addREss citY statE Zip...codE the vehicle is temporarily located out of state because the vehicle cannot or is not required to be registered in the state of because the above vehicle will continuously be located outside california until. the required smog certification will be obtained and submitted to dmV upon the vehicle s return to california* Contact information of person operating the vehicle out of state tRuE full NamE daYtimE tElEphoNE NumbER Section 2 certificAtion the informAtion you Are proVidinG iS Subject...to VerificAtion by dmV And your reGiStrAtion mAy be Subject to cAncellAtion* ExEcutEd oN DAte at City I certify or declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. STATE OF CALIFORNIA DEPARTMENT OF MOTOR VEHICLES A Public Service Agency ApplicAtion for temporAry SmoG exemption for A Vehicle locAted out-of-StAte h Sc 44011 cVc 20 1653 8800 Your vehicle may qualify for temporary exemption from biennial smog requirements if it is...temporarily located out of state. You must provide the following information in order to determine eligibility for the exemption* Section 1 Vehicle informAtion VEhiclE idENtificatioN NumbER as of datE YEaR makE modEl VEhiclE licENsE NumbER the vehicle has been located outside of california and is currently physically located/garaged at stREEt addREss citY statE Zip codE the vehicle is temporarily located out of state because the vehicle cannot or is not required to be registered in the state of...because the above vehicle will continuously be located outside california until. You must provide the following information in order to determine eligibility for the exemption* Section 1 Vehicle informAtion VEhiclE idENtificatioN NumbER as of datE YEaR makE modEl VEhiclE licENsE NumbER the vehicle has been located outside of california and is currently physically located/garaged at stREEt addREss citY statE Zip codE the vehicle is temporarily located out of state because the vehicle cannot or...is not required to be registered in the state of because the above vehicle will continuously be located outside california until. the required smog certification will be obtained and submitted to dmV upon the vehicle s return to california* Contact information of person operating the vehicle out of state tRuE full NamE daYtimE tElEphoNE NumbER Section 2 certificAtion the informAtion you Are proVidinG iS Subject to VerificAtion by dmV And your reGiStrAtion mAy be Subject to cAncellAtion*...ExEcutEd oN DAte at City I certify or declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.