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documents/dmv/civic_2016_registration/title_application.md

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+---
+type: dmv form
+category: title/registration application
+person: Xuewei Jiang
+date: 2021-07-29
+source: title_application.pdf
+---
+
+# Application for Title or Registration (REG 343)
+
+**Form:** REG 343 (REV. 4/2021) WWW
+**Agency:** State of California, Department of Motor Vehicles - A Public Service Agency
+
+---
+
+## Section 1 -- Vehicle Information
+
+| Field | Value |
+|---|---|
+| **Vehicle Identification Number** | 19XFC2F7XGE093564 |
+| **Vehicle Make** | Honda |
+| **Year Model** | 2016 |
+| **Fuel Type** | Gas |
+| **California License Number** | *(blank)* |
+| **Model or Series** | Civic |
+| **Body Type Model** | EX |
+| **Motorcycle Engine Number** | *(blank)* |
+
+**Type of Vehicle:** [X] Auto (includes truck or pickup)
+
+**For Trailer Coaches Only:** *(not applicable)*
+
+- Will this vehicle be used for the transportation of persons for hire, compensation, or profit? **No** [X]
+- Is this a commercial vehicle that operates at 10,001 lbs. or more? **No** [X]
+
+**For Commercial Vehicles Only:** *(not applicable)*
+
+---
+
+## Section 2 -- Owner Information
+
+| Field | Value |
+|---|---|
+| **True Full Name of Owner** | *(blank)* |
+| **Driver License/ID Card Number** | *(blank)* |
+| **Co-Owner/Lessee** | *(blank)* |
+| **Physical Residence or Business Address** | 11950 Idaho Ave. |
+| **Apt./Space/Ste. No.** | Apt. 113 |
+| **City** | *(blank)* |
+| **State** | CA |
+| **Zip Code** | 90025 |
+| **County of Residence** | Los Angeles |
+| **Equipment Number** | *(blank)* |
+| **Mailing Address** | *(blank)* |
+| **Lessee Address** | *(blank)* |
+
+---
+
+## Section 3 -- Legal Owner (Lien Holder/Title Holder)
+
+**True Full Name of Bank/Finance Company or Individual:** None
+
+---
+
+## Section 4 -- Odometer Information
+
+- [X] As of this date is (if no change in ownership): **28,579** miles
+- Odometer reading reflects the **ACTUAL** mileage
+- No odometer discrepancy noted
+
+---
+
+## Section 5 -- Date Information
+
+| Field | Value |
+|---|---|
+| **Date Vehicle Entered or Will Enter California** | Month: 11, Day: 21, Year: 2020 |
+| **Date Vehicle First Operated in California** | *(blank)* |
+| **Date You Went to Work in CA / Obtained CA DL / Became a Resident** | *(blank)* |
+| **Date Vehicle Was Purchased or Acquired** | Month: 10, Day: 23, Year: 2016 |
+| **Condition** | [X] New |
+| **Purchased** | [X] Outside CA |
+
+---
+
+## Section 6 -- Cost Information
+
+- [X] **PURCHASE** -- I purchased the vehicle for the price of $ *(amount blank)*
+
+**Vehicle Was Purchased or Acquired From:**
+- [X] Dealer
+
+**Body type modifications made?** *(not checked -- implied No)*
+
+---
+
+## Section 7 -- For Out-of-State or Out-of-Country Vehicles
+
+- Sales Tax paid to another state? [X] **N/A**
+- Disposition of Out-of-State Plates: [X] **Expired**, or will be or were
+
+---
+
+## Section 8 -- Military Service Information
+
+- Are you or your spouse on active duty as a member of the U.S. Uniformed Services? **No** [X]
+- When this vehicle was last licensed, were you or your spouse on active duty? **No** [X]
+
+---
+
+## Section 9 -- Certifications
+
+*I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct.*
+
+| Field | Value |
+|---|---|
+| **Printed Name** | Xuewei Jiang |
+| **Owner's Signature** | X *(signed)* |
+| **Date** | 07/29/2021 |
+| **Daytime Telephone Number** | (254) 214-9350 |
+| **Co-Owner** | *(blank)* |