Fillable Form VSA 17A: Virginia Vehicle Registration

What is the Virginia Vehicle Registration Form?

Form VSA 17A, Application for Certificate of Title and Registration, or also known as the Virginia Vehicle Registration Form is a document issued by the Virginia Department of Motor Vehicles used to get a title and registration for a motor vehicle in Virginia. This document is necessary to establish you as the new legal operator of the vehicle and to provide proof of ownership.

Where to get a Virginia Vehicle Registration Form?

Here are the following ways to obtain a Virginia Vehicle Registration Form:

In-person

You can get a blank copy of a Virginia Vehicle Registration Form in the Virginia Department of Motor Vehicles Service Center.

Wisconsin's local agencies websites.

A blank copy of a Virginia Vehicle Registration Form that you can download and manually fill out is available on the Virginia Department of Motor Vehicles' website.

PDFRun

For your convenience, you may electronically fill out the Virginia Vehicle Registration Form on PDFRun.

How to fill out the Virginia Vehicle Registration Form?

Here is a detailed guide on how to fill out a Virginia Vehicle Registration Form:

Owner Information

Application Type

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

• Title
• Title and Registration (license plate issued)

Electronic Title Option

Mark Yes, if you want DMV to maintain an electronic certificate of title on file for this vehicle; otherwise, mark No.

Vehicle Ownership

Mark the appropriate box to determine the ownership type of the vehicle. You may select:

• Vehicle is owned by individual(s).
• Vehicle is business owned.

If the application is for joint ownership

Mark Yes, if you wish clear rights of ownership to be transferred to the surviving owner in the event of the death of either the owner or co-owner; otherwise, mark No.

Owner’s Full Legal Name

Enter the owner’s full legal name in the following format: Last Name, First Name, Middle Initial, Suffix. If it is business owned, enter the name of the business.

Telephone Number:

Enter the owner’s telephone number.

DMV Customer Number/FEIN/SSN

Enter the owner's DMV Customer Number, Federal Employer Identification Number (FEIN), or Social Security Number (SSN).

Co-owner’s Full Legal Name

Enter the co-owner’s full legal name in the following format: Last Name, First Name, Middle Initial, Suffix.

Telephone Number:

Enter the co-owner’s telephone number.

DMV Customer Number/FEIN/SSN

Enter the co-owner’s DMV Customer Number, Federal Employer Identification Number (FEIN), or Social Security Number (SSN).

Residence/Business Jurisdiction

Enter the residence or the business jurisdiction.

Owner’s Street Address

Enter the owner’s street address, including the Apartment number, City, State, and ZIP Code.

Owner’s Mailing Address

If different from the street address, enter the owner’s mailing address, including the City, State, and ZIP Code.

Co-owner’s Street Address

Enter the co-owner’s street address, including the Apartment number, City, State, and ZIP Code.

Co-owner’s Mailing Address

If different from the street address, enter the co-owner’s mailing address, including the City, State, and ZIP Code.

Location where the vehicle is principally garaged

Mark the appropriate box to determine the type of location where the vehicle is principally garaged. You may select:

• City
• County
• Town

After marking the type of location, enter the specific area where the vehicle is principally garaged, for example, the City of Chesapeake.

Are any of the owners or lessees on active military duty or service

Mark Yes, if any of the owners or lessees are on active military duty; otherwise, mark No.

Registration Mailing Address

If you would like your registration renewal sent to a different address other than your residence or business address, enter an address, including the City, State, and ZIP Code. This is optional.

Vehicle Information

Year

Enter the vehicle's model year.

Make

Enter the vehicle's make.

Model

Enter the vehicle's model.

Body Type

Enter vehicle's body type.

Vehicle Identification Number (VIN)

Enter the vehicle's Vehicle Identification Number.

Number of Axles

Enter the vehicle's number of axles.

Empty Weight

Enter the vehicle's empty weight.

GVWR

Enter the vehicle's Gross Vehicle Weight Rating.

Gross Weight

Enter the vehicle's gross weight.

GCWR

Enter the vehicle's Gross Combined Weight Rating.

Fuel Type

Enter the vehicle's fuel type.

Vehicle Color

Primary

Enter the vehicle's primary color.

Is this a low-speed vehicle?

Mark Yes, if the vehicle is a low-speed vehicle; otherwise, mark No.

Is this a lodging vehicle?

Mark Yes, if the vehicle is a lodging vehicle; otherwise, mark No.

Is vehicle state or locality owned?

Mark Yes, if the vehicle is state or locality owned; otherwise, mark No. If marked Yes, enter the agency code.

Division Code

Enter the vehicle's division code.

Previous Title Number

Enter the vehicle's previous title number.

State

Enter the state where the vehicle was previously registered.

Lien Information

Is there a Lien on this vehicle?

Mark Yes, if there is a lien on this vehicle; otherwise, mark No.

If Yes, answer the succeeding items in this section. If No, proceed to the next section.

Date of First Lien

Enter the date of the first lien in the following format: Month, Date, Year.

Lienholder Name

Enter the lienholder's name.

Lienholder Code

Enter the lienholder code.

Lienholder Mailing Address

Enter the lienholder's mailing address, including the City, State, and ZIP Code.

Source of Ownership Information

How was this vehicle sold to you?

Mark the appropriate box to determine how this vehicle was sold to you. You may select:

• Used
• New
• Demonstrator

Purchase Date

Enter the vehicle's purchase date in the following format: Month, Day, Year.

Rentor Number

Enter the rentor number.

Sales Price

Enter the vehicle's sales price.

Processing Fee

Enter the vehicle's processing fee.

Sales and Use Tax

Enter the amount of the vehicle's sales and use tax.

Vehicle Purchased From

Enter the name of where the vehicle was purchased.

Street Address

Enter the address where the vehicle was purchased, including the City, State, and ZIP Code.

Dealers only:

VA Dealer License Number

Enter the VA Dealer License Number.

Manufacturer Rebate or Incentive

Enter the amount of manufacturer rebate or incentive.

Lease Information (if applicable)

Lessee’s Full Legal Name

Enter the lessee's full legal name in the following format: Last Name, First Name, Middle Name, Suffix.

Telephone Number

Enter the lessee's telephone number.

DMV Customer Number/FEIN/SSN

Enter the lessee's DMV Customer Number, Federal Employer Identification Number (FEIN), or Social Security Number (SSN).

Lessee’s Residence/Business Address

Enter the lessee's residence address or the business address.

Odometer Statement

Odometer Reading (no tenths)

Enter the vehicle's odometer reading without tenths.

Mark the appropriate box that certifies your vehicle's odometer reading. You may select:

• The odometer reading above is the ACTUAL MILEAGE of the vehicle.
• The odometer reading above is NOT the ACTUAL MILEAGE. (Odometer discrepancy.)
• The odometer reading above is IN EXCESS of its mechanical limits.
• The model year is at least 10 years or older than the current calendar year and was exempt from disclosure in the prior state of title (applicant must present out-of-state title showing exemption)

Personal Property Tax Relief Eligibility

Item 1a

Mark Yes if more than 50% of the vehicle's annual mileage is used as a business expense for federal income tax purposes or reimbursed by an employer; otherwise, mark No.

Item 1b

Mark Yes if more than 50% of the depreciation associated with the vehicle is deducted as a business expense for federal income tax purposes; otherwise, mark No.

Item 1c

Mark Yes if the cost of the vehicle expensed pursuant to Section 179 of the Internal Revenue Service Code; otherwise, mark No.

Item 1d

Mark Yes if the leasing company pays the tax without reimbursement from the individual leasing the vehicle; otherwise, mark No.

Item 2

Mark Business Use if you answered Yes to any of the questions in items 1a-1d. Your vehicle is considered by State law to have a business use and does not qualify for Personal Property Tax Relief.

Item 3

If you answered No to all of the questions in items 1a-1d, check Personal Use.

Mark Yes if this vehicle is held in a private trust for non-business purposes by an individual beneficiary; otherwise, mark No.

Insurance Certification

I/We certify that

Mark the appropriate box that determines your vehicle's insurance. You may select:

• This vehicle is insured by a liability policy issued through an insurance company licensed to do business in Virginia and it will remain insured while registered, whether or not it is operated. Penalties are severe for violation of this requirement. Be advised that the amount of liability coverage required is higher for vehicles that are operated for hire.

• This vehicle is not insured; therefore, I am remitting the applicable uninsured motor vehicle fee. (This fee provides no insurance coverage.) A vehicle must be insured with liability coverage when it is registered, and it must remain insured while registered, whether or not it is operated, or the uninsured motor vehicle fee must be paid. Penalties are severe for violation of this requirement.

Registration Information

Registration Period

Mark one of the boxes to determine your vehicle's registration period. You may select:

• One year
• Two years ($2 discount)
• Three years ($3 discount)
• Transfer — When marked, enter the vehicle’s plate number.

Registration Type

Mark one of the boxes to determine the type of registration you are applying for. You may select:

• Private
• Rental
• For hire — When marked, complete the For Hire Information section below.
• Trailer Permanent - (one-time fee) — If marked, select either regular or small plate size (trailer gross weight must be 4000 lbs or less).

For Hire Information

Mark all the boxes that indicate how the vehicle that is being registered will be used. You may select:

If for passenger carrier operations:

• Common Carrier - Regular Route
• Employee Hauler
• Sight-seeing Carrier Property Carrier
• Common Carrier - Irregular Route
• Contract Passenger Carrier
• Non-Emergency Medical Transport
• Nonprofit/Tax-Exempt
• Taxicab
• Exempt Operations - Passengers — When marked, complete the For Hire Information section below.

If for property carrier operations:

• Property Carrier — When marked, complete the For Hire Information section below.
• Household Goods Carrier — When marked, complete the For Hire Information section below.
• Exempt Operations - Property — When marked, complete the For Hire Information section below.

If the vehicle will be used in property carrier operations, and those operations exclusively use passenger cars, motorcycles, autocycles, mopeds, or vehicles with a gross vehicle weight rating (GVWR) of 10,000 pounds or less, then registration for hire is not required.

Mark Yes if you hold a valid intrastate operating authority certificate or permit; otherwise, mark No. If No and you are a passenger carrier, you must also complete the For-Hire Vehicles Registration Request, Form MCS115.

Certification

Applicant Name

Print the applicant's name.

Signature of the Applicant

Affix the applicant's signature

Date

Enter the date when the form was signed by the applicant.

Co-applicant Name

Print the name of the co-applicant.

Signature of the Co-applicant

Affix the signature of the co-applicant.

Date

Enter the date when the form was signed by the co-applicant.

How Much Is Vehicle Registration in Virginia?

When you submit your Virginia Title Application Form, you are required to pay a $15 titling fee. However, for Virginia Vehicle Registration fee, it depends on the classification and weight of the vehicle:

• Passenger vehicles, 4,000 lbs or less - $40.75
• Passenger vehicles and pickup trucks, 4,001 to 6,500 lbs - $45.75
• Pickup trucks, 6,501 to 10,000 lbs - $51.75
• Electric vehicles - $64.00
• Mopeds - $20.25
• Motorcycles - $28.75
• Autocycles - $25.75
• Low-speed vehicles - $40.75
• Antique vehicles - $50.00

Reminders in filling out the Virginia Vehicle Registration Form

• Take time to read the form’s instructions.
• Double-check answers to avoid errors.

• Provide all the information and signatures needed in this form.
• Complete and submit to any DMV customer service center (CSC). DMV may request proof of any information provided.
• Owners (and lessees, if applicable) must provide their residence/home/business address in the form. This address cannot be a P.O. Box. You must complete Form ISD-01 if you would like your address to be updated.
• For additional liens, complete Form VSA 66 and attach it to this form
• Failure to complete the statement or providing a false statement may result in fines, imprisonment, or both.
• Virginia offers more than 200 unique plates for our customers. Please visit www.dmvNow.com for a listing of special plates available. Not all plates are available for all vehicle types and some special plates require a certification form. Visit the Virginia DMV website for additional information.