Application for Certificate of Ownership for a New Vehicle

New Jersey Motor Vehicle Commission

For MVC Use Only:

Agency Full Transaction ID:

Application for Certificate of Ownership for a New Vehicle

Please complete and submit with Manufacturer's Certificate of Origin

Section A: Dealership Information

Place Dealer Stamp Here

New Vehicle Dealership (Licensed Business Name): Address: Motor Vehicle Dealer Identification Number:

Section B: Vehicle Information

Vehicle Make: ____________________________ Model: ____________________ Vehicle Identification Number (17 digits): __________________________________ What is the average EPA miles/gallon rating? (Add both city and highway ratings and divide by 2)

Section C: Transaction Information

LIST THE FOLLOWING:

1. The vehicle gross sales/lease price (excludes trade-in, manufacturers rebates, or additional Handicapped Driver Adaptive Equipment) $

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2. The vehicle net sales/lease price (after trade-in or manufacturers rebates).............................................................................

$

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3. The amount of sales tax due..................................................................................................................... $

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4. Indicate tax exemption code (if applicable).....................................................................................................

Section D: Questions

YES NO 1. Is the gross sales/lease price of the vehicle (designated in Section C, Item 1) equal to or greater than $45,000.00

AND is the average EPA MPG rating over 40? (Add both city and highway ratings and divide by 2)..........................................

2. Is the new vehicle certified as a zero emission vehicle by the Commissioner of Environmental Protection?................

3. Will the new vehicle be registered as a commercial vehicle?.......................................................................................

4. Is the purchaser/lessee a non-resident of New Jersey?................................................................................................ If you answered YES to any of the above questions, then skip to Section F.

Section E: NEW Luxury or Fuel Inefficient Vehicle Surcharge Calculation

The surcharge applies to passenger vehicles, light trucks, SUVs, and vans that will not be registered for commercial purposes. YES NO

Is the gross sales/lease price equal to or greater than $45,000.00 with an average EPA MPG rating of less than 40?.....

Is the gross sales/lease price less than $45,000.00 with an average EPA MPG rating of less than 19?............................

If you answered YES to either of these questions, then the surcharge is applicable.

Calculate 0.4% of the gross sales/lease price as designated in Section C, Item 1.

Amount of Surcharge assessed....................................................................................................................................... $

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Section F: Dealer's Signature

Dealership Authorized Signature: ___________________________________________ Date:_________________________

OS/SS-14 (7/06)

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