735 6511
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DMV DEPARTMENT OF TRANSPORTATION DRIVER AND MOTOR VEHICLE SERVICES 1905 LANA AVE NE, SALEM OREGON 97314 ASSEMBLED, RECONSTRUCTED OR REPLICA VEHICLE CERTIFICATION Instructions on back REQUIREMENTS: a. Title or Salvage Title for the frame or unibody used in the vehicle (if not previously surrendered to DMV). b. Evidence of ownership for each major part used, such as bill(s) of sale, a title or a -anufacturer’s #ertificate of /rigin (MCO). If building or rebuilding a vehicle from a kit, you must provide the MCO for the kit. Major parts may be the body (if not unibody), engine, kit, or axles (if a trailer). c. Application for Title and Registration (Form 735-226). The vehicle description in Section 1 must match the application. d. Applicable fees. e. 6ehicle )dentification .umber (VIN) INSPECTION 4HERE IS A FEE FOR THE INSPECTION .OTE 4HE ACTUAL 6). INSPECTION IS REQUIRED SEPARATE FROM THIS FORM As defined on the back of this form (see definitions of Reconstructed, Assembled and Replica on back), I certify this vehicle is: (Check the appropriate box) Reconstructed Assembled Replica I further certify that if the frame or unibody used in constructing this vehicle contains a Vehicle Identification Number (VIN), the number is shown as the VIN in Section 1 below. SECTION 1 - Vehicle Description PLATE YEAR MAKE Major parts used (check the appropriate box): BODY STYLE FRAME VIN OR SERIAL NUMBER (see definition of “major parts” on back) No major parts used. Listed in Section 2 below. Explain what you did to build or rebuild the vehicle. Identify all major parts used and what vehicle they came from. List the identification number of the part or vehicle from which the part was taken. SECTION 2 PART NAME AND VIN OR SERIAL NUMBER PART NAME AND VIN OR SERIAL NUMBER I understand it is a crime, under ORS 803.070 and 803.075, to knowingly make any false statement relating to the application or assignment of a title to a vehicle. This offense is a Class A misdemeanor and is punishable by a jail sentence of up to one year, a fine of up to $6,250, or both. 02).4%$ .!-% 3)'.!452% $!4% 8 117 STK# 300293 INSTRUCTIONS: Complete and sign this form and submit it, along with all requirements listed on the front, to any full service Oregon DMV office for processing. This form must be completed for a vehicle under any of the following conditions: abandoned and subsequently sold pursuant to ORS 819; assembled; dismantled; disassembled; destroyed; reconstructed; a replica; substantially altered; wrecked; totaled or an Oregon 6alvage 7itle has been issued for reasons other than theft. When the vehicle is titled, it will carry the appropriate brand. Read the definitions below and mark the box on the front that properly identifies how the title is to be branded. Any vehicle that is also totaled will carry a “totaled” brand along with one of the brands defined below. DEFINITIONS RECONSTRUCTED: a. Has a body that resembles and primarily is a particular year model or make of vehicle, and b. Is not a vehicle rebuilt by a manufacturer, and c. Is not built in a factory where the year model and make are assigned at the factory, and d. Is not a replica. OR Is a motor truck that has been rebuilt using a component kit if the manufacturer of the kit assigns a 6ehicle )dentification .umber and provides a -anufacturer’s #ertificate of /rigin for the kit. ASSEMBLED: a. The body does not resemble any particular year model or make of vehicle, and b. Is not rebuilt by a manufacturer, and c. Is not built in a factory where the year model and make are assigned at the factory, and d. Is not an antique, special interest, reconstructed, or replica vehicle. REPLICA: A vehicle with a body built to resemble and be a reproduction of another vehicle of a given year and given manufacturer. This includes vehicles that: a. Are built as replicas from new, reconditioned, or original parts, or b. Are reconstructed from existing vehicles or parts of existing vehicles, and which otherwise meet the definition of a replica. In these situations, the title and title record shall reflect that the vehicle is a “replica” rather than “reconstructed.” TOTALED VEHICLE: a. A vehicle declared as a total loss by an insurer that is obligated to cover the loss or that the insurer takes possession of or title to, or b. A vehicle that has sustained damage that is not covered by an insurer and that is such that the estimated cost to repair the vehicle is equal to at least 80% of the retail market value of the vehicle prior to the damage. “Retail market value” shall be as reflected in publications relied upon by financial institutions doing business in this state, or c. A vehicle that is stolen, if it is not recovered within 30 days of the date that it is stolen, and if the loss is not covered by an insurer. Note: Even if a vehicle that has been totaled or sold under ORS 819 has no repairs made, it must be titled as an assembled, reconstructed or replica vehicle. See the definition of a totaled vehicle above. MAJOR PARTS: (Other than the frame or unibody) Buses: .......................................................... Body (if not unibody), engine, kit Campers: ...................................................... Body Heavy Trailers: ............................................. Axle and body Motor Homes: .............................................. Body (if not unibody), engine, kit Motorcycles: ................................................ Engine, transmission Passenger Vehicles: ................................... Body (if not unibody), engine, kit Trucks: ......................................................... Engine, cab or kit (must have an MCO if a kit)
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