Form 4374 - Application For Registration As A Fleet Vehicle Owner

Download a blank fillable Form 4374 - Application For Registration As A Fleet Vehicle Owner in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form 4374 - Application For Registration As A Fleet Vehicle Owner with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

Reset Form

Print Form

MISSOURI DEPARTMENT OF REVENUE

FLEET NUMBER

NEW FLEET

FORM

MOTOR VEHICLE BUREAU

ADD VEHICLES

4374

APPLICATION FOR REGISTRATION

TELEPHONE NUMBER

FAX NUMBER

AS A FLEET VEHICLE OWNER

(REV. 8-2012)

( __ __ __ ) __ __ __ - __ __ __ __

FLEET NAME (LEGAL NAME)

REGISTRATION CYCLE

ANNUAL

BIENNIAL

Registration cycle will be applied to all fleet registration applicable

to fleet company.

CONTACT PERSON

REQUESTING NAME/LOGO ON PLATE

YES

E-MAIL ADDRESS

Companies wishing to display fleet plates with company name or

logo will be required to pay an initial $5.00 per registration. Only

CATEGORY

QUANTITY REQUESTED

fleets with 50 or more vehicles are eligible for logos on their fleet

MAILING ADDRESS

plates.

COMPLETE ALL NUMBERS BELOW THAT APPLY:

US DOT NUMBER

MO DOT NUMBER

FEDERAL EMPLOYEE ID NUMBER

DLN

__ __ __ __ __ __ __

__ __ __ __

__ __ __ __ __ __ __ __ __ __

__ __ - __ __ __ __ __ __

You must own 10 or more motor vehicles to qualify as a fleet vehicle owner. All motor vehicles must be titled in the exact same name as shown above.

Trailers cannot be registered as fleet vehicles. List below the motor vehicles to be registered in your fleet. (Print/copy this form to attach additional

sheets, if necessary)

CURRENT PLATE

TITLE NUMBER

YEAR

MAKE

VEHICLE IDENTIFICATION NUMBER

NUMBER

__ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __

10.

__ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __

11.

__ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __

12.

__ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __

13.

__ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __

14.

__ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __

15.

__ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __

16.

__ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __

17.

__ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __

18.

__ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __

19.

__ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __

20.

__ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

__ __ __ __ __ __

If you are requesting your company logo or name on your fleet plates, you will need to submit an initial $5.00 fleet logo fee at the time of application.

The fees may be submitted in a check payable to the Department of Revenue or by credit card. Complete the following information to have the fees

charged to your credit card. A service fee will apply.

TYPE OF CREDIT CARD

CREDIT CARD NUMBER

EXPIRATION DATE

__ __ / __ __ / __ __ __ __

NAME AS SHOWN ON CREDIT CARD

AUTHORIZED SIGNATURE

DATE

__ __ / __ __ / __ __ __ __

I certify under penalty of perjury that the facts provided herein or in conjunction with this application are true to the best of my knowledge.

SIGNATURE OF OWNER/REPRESENTATIVE