3.3 KiB
3.3 KiB
type, category, person, date, source
| type | category | person | date | source |
|---|---|---|---|---|
| dmv form | title/registration application | Xuewei Jiang | 2021-07-29 | 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
- 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
- PURCHASE -- I purchased the vehicle for the price of $ (amount blank)
Vehicle Was Purchased or Acquired From:
- 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) |