Non-Use of Motor Vehicle Declaration Form
Please complete this form to declare that you did not use your motor vehicle during the specified period or for the specified purpose.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Vehicle Registration / Plate Number
*
Vehicle Make and Model
*
Non-Use Period Start Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Non-Use Period End Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason for Non-Use
*
Vehicle under repair
Seasonal storage
Travel or absence
Not required for intended purpose
Other
Declaration Statement: I hereby declare that the above-named vehicle was not used during the period stated for the reasons provided. I understand that providing false information may have legal consequences.
*
I acknowledge and agree
Signature
*
Submit Declaration
Submit Declaration
Should be Empty: