Fillable Form Arizona Vehicle Registration (96-0236)

What is the Arizona Vehicle Registration Form?

Form 96-0236, Title and Registration Application, also known as the Arizona Vehicle Registration Form, is a form provided by the Motor Vehicle Department of Arizona to register their vehicle when they buy one. It may also be used to duplicate your registration or request a new registration when your vehicle was stolen, salvaged, or dismantled.

You may download a PDF copy of the Arizona Vehicle Registration Form from the Arizona Department of Transportation website. For convenience, you may fill out the Arizona Vehicle Registration Form on PDFRun.

How to fill out the Arizona Vehicle Registration Form?

Residents of Arizona must fill out the form for their vehicle registration with the MVD. Vehicles bought outside Arizona must be registered to operate within the state.

Application

Mark the appropriate box to determine what you are applying for with the AZ MVD. You may select:

• Title and Registration
• Title Only
• Duplicate
• Registration Only
• Dismantle
• Salvage
• Stolen

Plate Number

Enter the plate number of your vehicle.

Plate Credit No.

Enter the plate credit number.

Credit Eff. Date

Enter the credit effective date.

First Registered

Enter when the vehicle was first registered.

Reg. Eff. Date

Enter the date when the registration became effective.

Registration Expiration Date

Enter the expiration date of the registration.

The following fields below are your vehicle’s information. Enter the necessary information below, and make sure that they are accurate and correct.

Unit Number

Enter the unit number.

Mobile Home W/L

Enter the vehicle’s mobile home with land.

Vehicle Identification Number

Enter the vehicle identification number of your vehicle.

Make

Enter the make of the vehicle.

Body Style

Enter the body style of the vehicle.

Year

Enter the year of the vehicle.

Model

Enter the model of the vehicle.

List Price

Enter the list price of the vehicle.

GVW

Enter the vehicle’s gross vehicle weight.

Fuel

Enter the fuel of the vehicle.

Odometer Reading (no tenths)

Enter the odometer reading of the vehicle.

Odometer Codes

Mark the appropriate code of the vehicle. You may select:

• A
• B
• C

Code A means that the mileage stated reflects the actual mileage. Code B means that the mileage stated is in excess of the odometer’s mechanical limits. Lastly, Code C means that the odometer reading is not the actual mileage. If the odometer of your vehicle is Code C, MVD warns the owner that it is an odometer discrepancy.

Vehicle Construction

Mark the appropriate box for the construction of the vehicle. You may select:

• Specially Constructed
• Reconstructed

Trailer Plate Size

Mark the appropriate box the trailer plate size of your vehicle. You may select:

• Full Size
• Small

Lien Amount

Enter the lien amount of the vehicle.

Lien Date

Enter the lien date.

Additional Lien or lienholders

Mark the box if the vehicle has additional lien or lienholders. If you mark this box, you need to attach another application.

Lienholder Driver License or EIN

Enter the driver’s license of the Employer Identification Number (EIN) of the lienholder of the vehicle.

Lienholder Name (if no lien, write NONE)

Enter the name of the lienholder. If there is no lien on the vehicle, write “NONE.”

Legal Status

Check the appropriate box for the legal status of the lienholder. You may select:

• Or
• And
• And/Or

Mailing Address

Enter the complete address of the lienholder, including the city, state, and ZIP code.

Owner Driver License or EIN

Enter the driver’s license or Employer Identification Number (EIN) of the owner.

Owner Name (first, middle, last, suffix)

Enter the full legal name of the owner of the vehicle.

Date of Birth

Enter the birthdate of the owner.

MVD Tax Account Number (if applicable)

Enter the MVD Account Number of the owner, if any.

The following fields below require your ownership over the vehicle, its current location, and service options. Enter the required fields below and read each field carefully.

Legal Status

This section applies if there are multiple owners of the vehicle. If there are multiple owners of your vehicle, you may select:

• Or
• And
• And/Or

The legal status section determines which signatures will be required to transfer ownership of the vehicle, license plates, license fees, to apply for a refund, or to record loan information.

“Or” means the ownership of the vehicle is a joint tenancy with an expressed intent that either of the owners has the authority over the vehicle. The signature of both owners is not necessary as either owner can sign. If you checked “Or,” affix your signature.

“And” means there is tenancy in common over the ownership of the vehicle. In this case, both signatures of the owners will be required in the legal status section.

“And/Or” means there is joint tenancy with a right of survivorship. If both owners are still living, both signatures are required. Upon proof of death, the survivor alone may sign this section.

Address

Enter the complete street address, city, state, ZIP, and County of the owner.

Mailing Address

Enter the complete mailing street address, city, state, ZIP, and County of the owner, if the address is different from above.

Note that the next two sections are the same as the first section requiring the owner’s information. Fill out the sections only if there is more than one owner of the vehicle.

Vehicle/Mobile Home Location

Enter the complete address, including the city, state, zip, and county of the vehicle.

Service Options

Enter the number of the service option that applies to you. You may enter:

• 1 - Alternative Fuel
• 2 - Tribal
• 3 - VA Grant
• 4 - VA Disability
• 5 - Widow/Totally Disabled Person
• 6 - Military
• 7 - Special Military
• 8 - Non-Government Emergency Services
• 9 - Survivor of Fallen Responder
• 10 - Nonprofit
• 11 - School or Church
• 12 - SSI
• 13 - Leased School Bus
• 14 - Health Officer
• 15 - One-Way Hauling
• 16 - Route Truck
• 17 - Agricultural Products
• 18 - For Hire
• 19 - Farm Vehicle
• 20 - Motion Picture Production
• 21 - Limited Mileage I
• 22 - Limited Mileage II

Date Vehicle Acquired

Enter the date when the vehicle was acquired.

Vehicle will be rented without a driver (such as a rental car).

Mark the box if your vehicle will be rented without a driver. Otherwise, leave it unmarked.

Certification

Mark the appropriate boxes if you consent to the following statements mentioned in the DMV Arizona Form.

Mark the box if you consent to the release of personal information contained in your driver’s license and vehicle record. Otherwise, leave it unmarked.

Mark the box if you certify that your vehicle is not maintained and operated for more than 1,000 hours in a vehicle registration year for the transportation of passengers or property for a commercial enterprise. Otherwise, leave it unmarked.

Mark the box if you certify that your trailer or semitrailer with a declared gross weight of 10,000 pounds or less is not maintained and operated for a commercial enterprise. Otherwise, leave it unmarked.

All Owners Sign Here

Affix your signature. If there are other owners, have them affix their signature here.

If “Or” is checked above, the owners must also sign the Legal Status boxes above.

How to file the Arizona Vehicle Registration Form?

The Arizona Vehicle Registration Form must be submitted once you obtained the resident status in Arizona. The completed form must be submitted to your nearest Arizona DMV Office or any Authorized Third Party provider within 15 days from buying your vehicle.

Take note that when you are registering the vehicle that you bought out of state, you must attach an out-of-state title on your application.