Registration/Vehicle

5. Plate Type

6. Registration Number

7. Previous Title #

8. State

ORIGINAL

Massachusetts Department of Transportation 3. Number of Documents______ rRO (Registration Only)

rRX (Registration Transfer)
RMV-1 Application Form
4. rST (Salvage Title)
rRT (Registration & Title)
rTAR (Title Add Registration)
www.massrmv.com
rTO (Title Only)
rSW (Summer/Winter Swap) rSS (Surviving Spouse)
1. REG. EFF . DATE
2. REG. EXP . DATE

9. Type of Registration:
10. Vehicle Identification Number:

q Passenger q Bus q Taxi q Livery q Commercial
q Trailer q Auto Home q Semi-Trailer q Motorcycle q Other ________________
11. Year

12. Make

13. Model Name

18. Transmission 19. Total Gross Weight (Laden)

q Automatic
q Manual

Owner

14. Model #

15. Body Style

20. Motor Power

q Diesel
q Hybrid

16. Circle Color(s) of Vehicle

0-Orange 1-Black 2-Blue 17. # of Cylinders/Passengers/Doors/Wheels
3-Brown 4-Red 5-Yellow 6-Green 7-White 8-Gray 9-Purple
/
/
/

q Gasoline
q Propane q Electric
q Other ___________

21. Bus: q Regular q DTE q Livery q Taxi q School Pupil

If carrying passengers for hire, max no of passengers that can be seated: ________

If school bus, is it used exclusively for city, town, or school district?

23. Owner # 2 License # / ID # / or SSN
24. EIN/FID # (see block 29)

22. Owner # 1 License # / ID # / or SSN

25. Owner # 1 Name (Last, First, Middle)

27. Owner # 2 Name (Last, First, Middle)

q Yes q No
If Sole Proprietor
provide SSN in #22

26. Owner # 1 Date of Birth

25a. Height
_____ Ft _____ In

25b. Sex
MALE

FEMALE

27a. Height
_____ Ft _____ In

27b. Sex
MALE

FEMALE

28. Owner # 2 Date of Birth

30. City/Town Where Vehicle is Principally Garaged:

29. Corp/Co/Organization Name (see block 24)

31. Mailing Address

City

State

Zip Code

32. Residential or Corp/Co/Organization Address (see block 24 and 29)

City

State

Zip Code

33A. Lessees MA License Number or EIN/FID Number. If out-of-state Lessee, use SSN and date of birth.
M M D D Y Y

33B. Lessees Name:

Sales or Use Tax Schedule

34. Lessees Address, City, State, and Zip Code

56 A. SALE BY LICENSED MOTOR VEHICLE DEALER

Title
37.

35. Date of Purchase

q New Vehicle
q Used Vehicle

36. Odometer Reading

38. Title Type: q Clear

q Owner Retained

39. Primary Salvage Title Brands:

qRepairable

q Salvage
q Theft

MA DOR-Registered Dealer EIN/FID # ______________________

q Reconstructed
q Prior Owner Retained

40. Secondary Salvage Brand(s)

q Parts Only

Lienholder

41. Date of 1st Lien

42. Date of 2nd Lien

I/we certify that all liens on this vehicle are listed below
44. Name
43. First Lienholder Code

Total Sale Price

$ ______________________
(adjusted for dealers discount and manufacturers rebate)
Less Manufacturers Excise

$ ______________________

Net Sales Price

$ ______________________

Less Trade-in Allowance For:

$ ______________________

Yr __________

Make_____________ Model_______________

Trade-in VIN ___________________________________________

45. Lienholders Address
46. Second Lienholder Code

47. Name

Taxable Sales Price

$ ______________________

6.25% Sales Tax

$ ______________________

B. SALES BY OTHER THAN MOTOR VEHICLE DEALER

48. Lienholders Address

Insurance Certification

The company signatory hereto hereby certifies that it has or will insure or guarantee performance by the applicant
hereinbefore named with respect to the motor vehicle hereinbefore described for a period at least coterminous with
that of such registration under a motor vehicle liability policy, binder or bond which conforms to the provisions of general laws, Chapter 175, Section 113A, and that the premium
charge and classification on the effective date of registration are as established by the commissioner of insurance under Chapter 175, Section 113B, 113H and Chapter 175E.

49A. Policy Effective Date:

_____________________

Gross Sales Price (Proof Required)

$ ______________________

6.25% Sales/Use Tax

$ ______________________

C. CLAIM EXEMPTION FROM TAX CODE: __________________

Form Attached (if required)
Exempt Organization Certificate #__________________________

49A. Policy Change Date:

_____________________
49B. Manual Class:
49C. Ins. Company & Code:

Fee Info.
Insurance Cos Authorized Representatives Signature (Original Only)

Signatures

I/We the applicants hereby certify under the penalties of perjury that there are no outstanding excise tax liabilities on the vehicle

described above that have been incurred by the applicant(s), any member of the applicants immediate family who is a member of
the applicants household or the business partner of the applicant(s). I/We hereby further certify that all information contained in this application is true
and correct to the best of my knowledge and belief. I/We understand that false statements are punishable by fine, imprisonment or both.

50. Signature of Owner From Block 25 or 29. If owner is listed in Block 29, signer must also print name.
51. Signature of 2nd Owner From Block 27.
52. Authorized Dealers Signature

57. Reg:

$ ___________________

Title:

$ ___________________

Tax:

$ ___________________

P&I:

$ ___________________

Total:

$ ___________________

Payment:

q Cash
q Check
q EFT/ CC
Clerk ID:

58. Batch No:

53. Dealer Reg. No.
59. Clerk/End User Initials:

54. Sellers Name (Please Print)

55. Sellers Address

Progressive
Ins. form
approved 1/2013
This form approved by the
RMV 1/2013
www.massrmv.com

www.massrmv.com
2. REG. EXP. DATE

1. REG. EFF. DATE

Registration/Vehicle

5. Plate Type

3. Number of Documents______ rRO (Registration Only)

rRX (Registration Transfer)

rRT (Registration & Title)
rTAR (Title Add Registration)
rSW (Summer/Winter Swap) rSS (Surviving Spouse)

4. rST (Salvage Title)

rTO (Title Only)
6. Registration Number

7. Previous Title #

8. State

REGISTRANT

Massachusetts Department of Transportation

RMV-1 Application Form

9. Type of Registration:
10. Vehicle Identification Number:

q Passenger q Bus q Taxi q Livery q Commercial
q Trailer q Auto Home q Semi-Trailer q Motorcycle q Other ________________
11. Year

12. Make

13. Model Name

18. Transmission 19. Total Gross Weight (Laden)

q Automatic
q Manual

Owner

14. Model #

15. Body Style

20. Motor Power

q Diesel
q Hybrid

22. Owner 1 License # / ID # / or SSN

16. Circle Color(s) of Vehicle

0-Orange 1-Black 2-Blue 17. # of Cylinders/Passengers/Doors/Wheels
3-Brown 4-Red 5-Yellow 6-Green 7-White 8-Gray 9-Purple
/
/
/

q Gasoline
q Propane q Electric
q Other ___________

21. Bus: q Regular q DTE q Livery q Taxi q School Pupil

If carrying passengers for hire, max no of passengers that can be seated: ________

25. Owner # 1 Name (Last, First, Middle)

27. Owner # 2 Name (Last, First, Middle)

q Yes q No

If school bus, is it used exclusively for city, town, or school district?

24. EIN/FID # (See block 29)

23. Owner 2 License # / ID # / or SSN

If Sole Proprietor
provide SSN in # 22

26. Owner # 1 Date of Birth

25a. Height
_____ Ft _____ In

25b. Sex
MALE

FEMALE

27a. Height
_____ Ft _____ In

27b. Sex
MALE

FEMALE

28. Owner # 2 Date of Birth

30. City/Town Where Vehicle is Principally Garaged:

29. Corp/Co/Organization Name (see block 24)

31. Mailing Address

City

State

Zip Code

32. Residential or Corp/Co/Organization Address (see block 24 and 29)

City

State

Zip Code

33A. Lessees MA License Number or EIN/FID Number. If out-of-state Lessee, use SSN and date of birth.
M M D D Y Y

33B. Lessees Name:

Sales or Use Tax Schedule

34. Lessees Address, City, State, and Zip Code

56 A. SALE BY LICENSED MOTOR VEHICLE DEALER

Title
37.

35. Date of Purchase

q New Vehicle
q Used Vehicle

36. Odometer Reading

38. Title Type: q Clear

q Owner Retained

39. Primary Salvage Title Brands:

qRepairable

q Salvage
q Theft

q Reconstructed
q Prior Owner Retained

40. Secondary Salvage Brand(s)

q Parts Only

MA DOR-Registered Dealer EIN/FID # ______________________

Total Sale Price
$ ______________________
(adjusted for dealers discount and manufacturers rebate)
Less Manufacturers Excise

$ ______________________

Net Sales Price

$ ______________________

Less Trade-in Allowance For:

$ ______________________

Yr __________

Make_____________ Model_______________

Trade-in VIN ___________________________________________

Taxable Sales Price

$ ______________________

6.25% Sales Tax

$ ______________________

B. SALES BY OTHER THAN MOTOR VEHICLE DEALER

Insurance Certification

The company signatory hereto hereby certifies that it has or will insure or guarantee performance by the applicant
hereinbefore named with respect to the motor vehicle hereinbefore described for a period at least coterminous with
that of such registration under a motor vehicle liability policy, binder or bond which conforms to the provisions of general laws, Chapter 175, Section 113A, and that the premium
charge and classification on the effective date of registration are as established by the commissioner of insurance under Chapter 175, Section 113B, 113H and Chapter 175E.

49A. Policy Effective Date:

_____________________

Gross Sales Price (Proof Required)

$ ______________________

6.25% Sales/Use Tax

$ ______________________

C. CLAIM EXEMPTION FROM TAX CODE: __________________

Form Attached (if required)
Exempt Organization Certificate #__________________________

49A. Policy Change Date:

_____________________
49B. Manual Class:
49C. Ins. Company & Code:

Fee Info.
Insurance Cos Authorized Representatives Signature (Original Only)

CERTIFICATE OF REGISTRATION

This document is the Certificate of Registration for the herein

described vehicle. Section 11, Chap. 90, MGL states ...Every
person operating a motor vehicle shall have the Certificate of
Registration for the vehicle and for the trailer, if any, and his
license to operate, upon his person or in the vehicle in some
easily accessible place.

57. Reg:

$ ___________________

Title:

$ ___________________

Tax:

$ ___________________

P&I:

$ ___________________

Total:

$ ___________________

Payment:

q Cash
q Check
q EFT/ CC
Clerk ID:

58. Batch No:

59. Clerk/End User Initials:

Not Valid Until Stamped With Official Stamp or Registrars Signature

Progressive
Ins. form
approved 1/2013
This form approved by the
RMV 1/2013
www.massrmv.com