ANTIQUE VEHICLE LICENCE

ANTIQUE VEHICLE LICENCE

(the Corporation) LICENSING OF AN ANTIQUE MOTOR VEHICLE/MOTORCYCLE

CHANGE PLATE OWNERSHIP

PLATE REPLACEMENT

VINTAGE NUMBER PLATE

The owner(s) of the described antique vehicle hereby applies under the Motor Vehicle Act and Regulation to the Insurance Corporation of British Columbia for an Antique Vehicle Licence.

PREVIOUS OWNER

OWNER'S NAME(S) SURNAME FOLLOWED BY GIVEN NAME(S) IN FULL

OWNER'S FULL RESIDENTIAL ADDRESS

VEHICLE DESCRIPTION REGISTRATION NUMBER

MODEL YEAR MAKE

VEHICLE IDENTIFICATION (SERIAL) NUMBER

MODEL

PROV POSTAL CODE

BC

PHONE NUMBER

BODY STYLE

ENGINE NUMBER

Fee Information: Licence and Plate Fee ? $53.00 Plate Replacement Fee ? $18.00

Payment Information: Please make cheques payable to ICBC. No fee is charged to change plate ownership.

IMPORTANT

Colour photographs of the vehicle, one each showing the front, one side, the interior of the engine compartment and the interior of the driver's compartment to be attached to this application.

I hereby declare that:

STATEMENT OF OWNER

1. I am a resident of British Columbia; 2. I am the owner of the vehicle described on this Antique Vehicle Licence; 3. This vehicle is 30 years of age or older and has been maintained as nearly as possible with

original component parts; 4. This vehicle will only be operated pursuant to Division 22 of the Motor Vehicle Act Regulations.

It is owned as a collector's item and will be operated solely for transportation to and from and used in exhibitions or club activities, parades, and other like functions, and for the purpose of obtaining vehicle repairs and servicing, and for presentation of the vehicle at a designated inspection facility, but not for use for general transportation; 5. This vehicle will not be operated on a highway without insurance coverage pursuant to the Insurance (Vehicle) Act and Regulation.

and I further declare that:

I, the owner, being 18 years of age or older, and if under 18 full years of age, having obtained parental consent, declare that to the best of my knowledge, the information shown hereon is correct.

By signature, the owner declares that the above information is true, and any inaccuracy howsoever caused therein is adopted as the responsibility of the owner.

SIGNATURE OF OWNER(S) (Or if a business, the signature of an authorized officer and title.)

ATTACHMENTS / AGENT'S COMMENTS

PREVIOUS MV1420

PREVIOUS VINTAGE NUMBER PLATE

PHOTOGRAPHS

OTHER

AGENT NO.

AGENT'S SIGNATURE

LICENCE/ PLATE FEE

$

PLATE REPLACEMENT FEE

$

TOTAL AMOUNT

$

TITLE

Complete application and forward to:

DATE

ICBC -- Collector Vehicle Department Room 235 -- 151 W Esplanade North Vancouver, BC V7M 3H9

NOT VALID UNLESS STAMPED BY AUTHORIZED ISSUING OFFICE

NOTES

1. The vintage licence plates must remain with the antique vehicle when it is transferred to a new owner.

2. The vintage licence plates and corresponding antique vehicle licence must be surrendered to: ICBC ? Revenue Stock

when: a) The vehicle is removed from the province of British Columbia.

PO Box 8800 Station Terminal Vancouver BC V6B 4E2

b) The vehicle no longer qualifies as an "Antique Motor Vehicle/Motorcycle" as defined in Section 22.01 of the Motor Vehicle Act Regulations.

MV1420 (062017)

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