Fillable Out-Of-Area Emissions Exemption Form (Page 2 of 2) in pdf

Instructions for Completing Form: Out-of-Area Emissions Exemption

If you live within either of the mandatory vehicle emissions test areas in Arizona, or if you commute into these areas

on a regular basis for work or school, you must have your vehicle emission tested. These test areas are defined in

statute by township and range. The Motor Vehicle Division (MVD) uses zip codes to identify whether a vehicle may

be subject to testing. However, some zip codes are not fully inside the test area, and contain areas exempt from

testing. This application is used to exempt vehicles from testing that are outside the test area and not used to commute.

It is also used to exempt vehicles registered on Gila River Tribal lands.

Address Verification:

Complete this section using the physical address of your residence (not the P.O.Box or mailing address, if different

from the actual location). Use your principle residence telephone number. If you have only a cell phone, note “cell”

after the number. If someone in your household commutes into the vehicle emissions test area for employment or is a

student at an Arizona college or university, check “Yes” and provide the employer or school information, as

applicable. Vehicles used to commute into the area for work or school must pass emissions inspection ARS 49-

542A. If you are unsure, include those addresses and ADEQ will confirm whether you need to be tested.

“Address Locator”

You may use the

tool to verify that your residence or workplace is outside of the emissions

control area and eligible for an exemption from testing. Go to:

Vehicle Identification:

If you checked “Yes” (commute to work or school) list in the highlighted area at the top of this section only the

vehicle(s) used to commute into the emission test area. These will not receive an exemption, and must be tested. If you

have no other vehicles you do not need to submit this form. Simply have your vehicles tested at the nearest emission

test station.

If you have vehicles that are not required to be tested (see above), please list the vehicle identification information in

the lower portion of the form on the lines that say “Exempt from test.” These vehicles will receive a special MVD

code so they can be registered without being tested.

Required Documentation:

THE FOLLOWING INFORMATION MUST BE PROVIDED TO VERIFY ELIGIBILITY AND PROCESS

YOUR APPLICATION, (EXCEPT FOR VEHICLES DOMICILED ON GILA RIVER TRIBAL LANDS).

A photocopy of the current Arizona registration for each vehicle listed.

A photocopy of a current Arizona bill or statement (e.g., utility bill, bank statement, phone bill,

insurance, etc.) in the name of the applicant, identifying the physical address of residence. (If you do

not own the property, a photocopy of the lease/rental agreement will be required.)

For vehicles domiciled on Gila River Tribal lands, a letter from the Tribal Authority stating the registered owner of

the vehicle is residing on Gila River Tribal lands must be submitted.

Signature:

Be sure to sign and date the application. Be aware, that providing false statements in this application is a violation

of ARS 49-550(D), and an act of perjury punishable by law.

You may then mail the completed application to the appropriate address below. For your convenience, you may e-mail

the completed application to the email address provided.

Vehicle Emissions Exemptions - Phoenix

Vehicle Emissions Exemptions - Tucson

1110 W. Washington Street, Phoenix, AZ 85007

4040 E. 29

Street, Tucson, AZ 85711

PH: 520-628-5651 FAX: 520-628-6139

PH: 602-771-3950 FAX 602-207-7020

Email:

PhxVeiCode52@azdeq.gov

Email:

TucVeiCode52@azdeq.gov

Out-Of-Area Emissions Exemption Form Page 2

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