MVR Form PDF

Vehicle Application Form FORM MV-
This form is to be filled by any person applying for; the registration, 7001
reregistration, alterations to registers particulars of a motor vehicle,
Please answer in CAPITAL letters where applicable and sign the Toll Free Number
declaration. For reference, see Instruction notes on the last page. If 0800117000
Section A : Applicant/ Transferee Details

1) Are you registering the motor vehicle/trailer/engineering plant in the name of an
NO (Fill part 3 and continue with part Yes (Fill part 2 and continue from part 4)
2) Name of Applicant(Individual): (In case of a minor, only details of the Guardian
a) Title(Optional) b) Surname/Maiden c) First Name d) Middle Name
MR RUTAGENGWA MODEST -
e) Acquired Name (if Different from Surname) f) Family/Father's Surname(If Different from
KAMURASE VEDEST
g) Sex/Gender Male Female h) Date of Birth Day/Month/Year

04/04/1983
3)Name of Applicant(Non Individual): Mr. MODEST RUTAGENGWA
4) Do you have a TIN? No(Fill part 3) Yes(if yes, provide TIN) 1001214579
5) Address in (This must be a permenent physical address. Complete boxes(a) to (h)

a) Plot Number b) Street Name c)Building Name
- - -
d) Trading Center e)District/City f) County/Municipality

BAYITA WAKISO MAKINDYE-SSABAGABO
g) Sub-County/Town Council/Division h)Village/Local Council/Zone

BUNAMWAYA DIVISION -
Section B : Purpose of the application

Indicate the purpose of the application by ticking appropriate box below. Note, the application
should be for one vehicle and for one purpose
Alternation to
First Time Transfer of
Re registration registrered Duplicate De registration
Registration particular Ownership
1. Motor Vehicle
2. Motor Cycle
3. Trailer
4. Engineering
Section C : Duplicates
1. Duplicate for: Registration number Duplicate registration book
2. Indicate the reason for the duplicate by ticking the appropriate box below:
Stolen Lost Destroyed
Others, specify
3. In case the log book or number plate was stolen, lost or a) Date of reported to Police
destroyed, was the matter reported to Police ? Day/Month/Year
No Yes (if yes, give details)
b) Name of police station c) Police Reference
4. Provide details of the vehicle below:

a) Registration number plates b) Registration Book Number
c) Name of present registered owner d) TIN of present Registered Owner
Section D : Particulars of the Vehicle

if the purpose of the application is transfer or duplicate, fill in details from no. 3 to 27 otherwise for registration and re
registration, fill in fields 1 to 27
1) Are you applying to register(or reregister) a used No Yes if yes, fill in the following
(a) Previous Registration
Day/Month/Year
(b) Date of Previous Registration 17/02/2020
(c) Country of registration JAPAN
2 (a) Indicate the category of number plates you are applying ORDINARY VEHICLES
(b) In case of personalized Number Plates, specify your -
3. Make of vehicle 4. Manufacturer's model 5. Country of orginin

TOYOTA COROLLA FIELDER DBA- JAPAN
6. Fees classification 7. Description of the body 8. Color

1 STATION WAGON SILVER
9. Year of manufacture 10. Attachment * Nil / Side Car 11 Fuel

2008 NIL PETROL
12. Power (cubic capacity) 13. Engine Number 14. Chassis Number
1490 1NZD124604 NZE1419078972
15. Net Weight (in Kgs) 16. Gross Weight (Laden) (in Kgs) 17. Weight system used if not
1200 1475
18. Size of tyres 19. Number of wheels 20. Number of axles

265/70R14 4 2
21. Seating Capacity 22. Purpose / Function 23. Category of Ownership

5 PRIVATE UGANDAN
24. Tax Category 25. Classification of Vehicle 26. Insurance Company

1 Motor Cars - Salons,Estates,Station Wagons and Sedan null
cars
27. Insurance * policy / Cover Note No. null
Section E: Declaration and Certification

I / we declare that the information given on this application is true and correct
and that failure to provide correct information may result in
delayed processing or rejection of this application prosecution
if this form is signed by a person other than the applicant, formal powers of
attonery will be required. in the case of a transfer, the transferee should fill in
1. First Name 2. Last Name Office
Signiture Date: Day/Month/Year
Name
2. First Name(Transferee) Last Name
Signiture
Signiture Date: Day/Month/Year Day/Month/Year
Date

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Vehicle Application Form FORM MV-

Section A : Applicant/ Transferee Details

g) Sex/Gender Male Female h) Date of Birth Day/Month/Year

3)Name of Applicant(Non Individual): Mr. MODEST RUTAGENGWA

5) Address in (This must be a permenent physical address. Complete boxes(a) to (h)

d) Trading Center e)District/City f) County/Municipality

g) Sub-County/Town Council/Division h)Village/Local Council/Zone

Section B : Purpose of the application

4. Provide details of the vehicle below:

c) Name of present registered owner d) TIN of present Registered Owner

Section D : Particulars of the Vehicle

(b) In case of personalized Number Plates, specify your -

3. Make of vehicle 4. Manufacturer's model 5. Country of orginin

6. Fees classification 7. Description of the body 8. Color

9. Year of manufacture 10. Attachment * Nil / Side Car 11 Fuel

18. Size of tyres 19. Number of wheels 20. Number of axles

21. Seating Capacity 22. Purpose / Function 23. Category of Ownership

24. Tax Category 25. Classification of Vehicle 26. Insurance Company

27. Insurance * policy / Cover Note No. null

Section E: Declaration and Certification

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