MOTOR TAX RENEWAL FORM RF100A

DO NOT USE THIS FORM TO REGISTER CHANGES OF OWNERSHIP (See Note B)

1. REGISTRATION NUMBER Make/Model

Colour(s) Chassis No.

APPLICANT
Mr, Ms, etc. First Name (s)
Address at which vehicle ordinarily
kept (Enter “as across” if vehicle is
Surname OR kept at Address across)
Company Name
Address

Town/City
County Phone NO.

Has your name/address changed (e.g. on marriage) since the vehicle was last taxed? YES NO

2. TAX CLASS (See Note C2) Private P Goods G Agricultural Tractor A Motor Cycle C

Other - please specify

3. INSURANCE DETAILS (See Note C3)

Insurance Company Name (NOT Broker)

Insurance Policy no.

Day Month Year

Expiry date of Insurance Certificate under Road Traffic Act 1961 , as amended

READ NOTE C4 BEFORE COMPLETING

4. MOTOR TAX RENEWAL DETAILS

All months between expiry of the last Motor Tax Disc Assessment
FROM FIRST DAY OF To LAST DAY OF
and start of new disc must be covered by a Past Owner,
Non-Use or Arrears Period. Month Year Month Year
4.1 Expiry date of Last Motor Tax Disc Arrears 15/4

4.2 Past Owner Period (if applicable) To Checked

4.3 Non-Use Period (if applicable) To

4.4 Arrears Period 1 (if applicable) To €

4.5 Arrears Period 2 (if applicable) To €

4.6 TAX DISC NOW REQUIRED: To €

OFFICE USE ONLY

5. DECLARATION (See Note C5)
CASH € PO € €
I declare that the particulars given on this form are correct.
CHQ € MO € TOTAL €
CR CARD €
VLC Disc Letter
Signature RBK
Date Rec’d
INS
Date Date Issued

YOU MUST SIGN FORM Day Month Year

6. CARD PAYMENT OPTION (See Note C6)

Vehicle Registration No. Card type: Master Card Visa Credit Visa Debit Laser
Card Account No. Card Expiry Date

Cardholder’s Name
Cardholders Address

Cardholder Signature Contact phone number

 orNew
or Newowner
ownerdetails
detailson
onthe
theVehicle
VehicleRegistration
RegistrationCertificate
Certificateand
and
send to Vehicle Registration Unit, Department of the Environment, Heritage and Local Government, Shannon Town Centre, Co.
send to Vehicle Registration Unit, Department of the Environment, Heritage and Local Government, Shannon Town Centre, Co. Clare.Clare.

//Registration
Registration
Certificateto
Certificate tothe
theMotor
MotorDealer.
Dealer.

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You MUSTcomplete
completeSectionSection1. 1.Section
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CANNOTbe beused
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address of PRIVATELY,
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orNew
or
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and Sport, inShannon
theShannon
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person but rather
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a trader
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companyto Vehicle
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special
Registration
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attention is
Unit,
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Department
required to ensure
the
ofthat
the Environment,
Environment,
the company
Heritage
Heritage
name and and
not
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the
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trading name is Shannon
used. The Town Centre,
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company
Co. Clare.
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name Clare.bethe
the
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If sold to aspecial
MOTOR attention
DEALER,is required
complete to ensure
Form that the
RF105 company
(form is will namefrom
available and notMotortheDealer)
trading and
name is used. The andcompany name must be
sameas
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stated on
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the company’s Certification
Certification ofIncorporation
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and will inmost
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trader Computer
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company, formof
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becompleted
completed andsigned
Sport,inShannon nameTown
thename Centre, Co. Clare and give the Vehicle Licensing Certificate// Registration
ofaaperson.
person. to the
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Incorporated company,
Certificate
Motor tothe
to
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Certificate the
the Motor
Motormust be
Dealer.
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You
You MUST
MUST complete
complete Section
Section 1. 1. Section
Section 11 CANNOT
CANNOT be be used
used to to register
register aa change
change of of ownership
ownership of of any
any kind
kind -- see
see Note
Note B B above.
above. Enter
Enter the
the name
name
and
and address
address ofof the
the person
person inin whose
whose name
name thethe vehicle
vehicle isis to
to be
be licensed.
licensed. IfIf the
the vehicle
vehicle is
is not
not being
being licensed
licensed in
in the
the name
name of of aa person
person butbut rather
rather aa trader
trader //
registered
registered company
company special
special attention
attention is
is required
required to
to ensure
ensure that that the
the company
company name name andand not
not the
the trading
trading name
name is is used.
used.The
The company
company name name must
must be be the
the
same
same asas that
that stated
stated on
on the
the company’s
company’s Certification
Certification of
of Incorporation
Incorporation and and will
will in
in most
most cases
cases have
have “Limited”
“Limited” in
in the
the name.
name. IfIf the
the trader
trader is
is not
not an
an
Incorporated
Incorporated company,
company, thethe form
form must
must be be completed
completed and
and signed
signed in in the
the name
name of of aa person.
person.

C3 Section 3

C4 Section 4 4.1 to 4.6

4.4
4.2, 4.3
4.1 4.1 September 2013, enter
this as 0 9 2 0 1 3
If the ownership of the vehicle has changed
4.2 If the ownership of the vehicle has changed since sinceititwas
waslast
lasttaxed,
taxed,youyouare
areNOT
NOTliable
liablefor
forthe
thearrears
arrearsperiod
periodfrom
fromthetheexpiry
expiryof
ofthe
thelast
lasttax
tax
disc to the end of the month immediately preceding the date of sale. If you are a new owner since the vehicle was last taxed and the renewal isisinin
disc to the end of the month immediately preceding the date of sale. If you are a new owner since the vehicle was last taxed and the renewal
respectof
respect ofaagoods
goodsvehicle
vehicleyou
youmust
mustproduce WeightDocket
produceaaWeight Docketand andififthe
therenewal
renewalisisininrespect
respectof of(i)
(i)aagoods
goodsvehicle
vehiclewhose
whoseunladen
unladenweight
weightdoes
does
notexceed
not exceed3,500kg
3,500kg(DGVW)
(DGVW)or or(ii)
(ii)aarecovery
recoveryvehicle,
vehicle,ititisisnecessary
necessaryto tocomplete
completeform
form(i) (i)RF111A
RF111Aor or(ii)
(ii)RF111B
RF111Bavailable
availablefrom
fromthe
theMotor
MotorTax
TaxOffice.
Office.

4.3 If the vehicle is currently declared off the road enter the period of non-use in the boxes provided.
4.4, If4.5 If there are elapsed months since the expiry ofit the last Motor Tax disc or off the road declaration, which was not covered by a Past Owner Period,
If the
the ownership
ownership of of the
the vehicle
vehicle has
has changed
changed since
since it waswas last
last taxed,
taxed, youyou are
are NOT
NOT liable
liable for
for the
the arrears
arrears period
period from
from the
the expiry
expiry ofof the
the last
last tax
tax
arrearsthe
disc are due. Entermonth
a continuous period of arrears indate the boxes providedare at 4.4 on owner
the form. If the arrears period is broken, enter the details using the
disc to to the end
end of
of the
the month immediately
immediately preceding
preceding the
the date of of sale.
sale. IfIf you
you are aa new
new owner sincesince the
the vehicle
vehicle was
was last
last taxed
taxed and
and the
the renewal
renewal is is in
in
boxes 4.4
respect of aand 4.5 on
goods the form.
vehicle you Enterproduce
must relevantaamount
Weight of arrears.
Docket and if the renewal is in respect of (i) a goods vehicle whose unladen weight does
respect of a goods vehicle you must produce a Weight Docket and if the renewal is in respect of (i) a goods vehicle whose unladen weight does
4.6exceed
not
not Enter the
exceed 3,500kg
renewal
3,500kg (DGVW)
periodor
(DGVW) you
or (ii) aa recovery
(ii)require and vehicle,
recovery the itit is
relevant
vehicle, is necessary
fee to
in the boxes
necessary to complete form
provided.
complete form (i)
(i) RF111A
RenewalRF111A or
or (ii)
options ofRF111B
(ii) 3 months,
RF111B available
6 months
available fromor the
from oneMotor
the Tax
year are
Motor Office.
Taxavailable
Office.
unless the annual fee is less than €119 in which case, only a renewal period of one year is available.
C5 Section 5- The signature on the application must be that of the owner of the vehicle (defined in Section 130 of the Finance Act, 1992 as the Keeper of
the vehicle). In the case of companies registered under the Companies Act 1963, the signature must be that of the Managing Director or Secretary. Where a
private firm is concerned, one of the partners’ signatures must be inserted.
C6 Section 6 - Complete this section if payment is being made by Credit Card or Debit Card. Card type: Please note Laser cards are not acceptable for
postal applications. Cardholder’s name – enter as it appears on the card.
D. What should accompany this form
You MUST County
include
County Council //City
CityCouncil
the following
Council Council andcrossed
crossed“Motor
with application:
and “MotorTaxTaxAccount”.
Account”.DO DONOT
NOTSEND
SENDCASHCASHTHROUGH
THROUGHTHE THEPOST.
POST.Contact
Contactyouryourlocal
localMotor
MotorTax
Tax
Office
• FeeOffice forclarification
- You for
mustclarification
include a ofofthe
theappropriate
cheque appropriate Motor
or postal order Tax
for therates or
correct other
fee payment
(including methods.
arrears Payments
where can also
appropriate), be
mademade by
payable credit
to the / debit card.
appropriate
Motor Tax rates or other payment methods. Payments can also be made by credit / debit card. (Motor (Motor
County
TaxRates
Ratesare
Council/Borough
Tax areCouncils
availableand
available onAertel
on AertelPage
crossedPage 454Tax
“Motor
454 (RTE
(RTE 2)or
orat
Account”.
2) atDO
www.motortax.ie,
NOT SEND CASH
www.motortax.ie, andselect
and select
THROUGH MotorTHE
Motor TaxRates.)
Tax Rates.)
POST. Contact your local Motor Tax Office for
clarification of the appropriate Motor Tax rates or other payment methods.
• Goods or Recovery Declaration, if applicable (see Note 4.2) and,,and aand
WeightWeight
aaWeight Docket
Docket ififownership
ownership
if ownership
Docket haschanged
has changed
has changed since
it wasititlast
sincesince wastaxed.
was lasttaxed.
last taxed.
• PSV (plate) Licence - Public Service Vehicles only.
• Article 60 Licence
County
County Council- /School
Council / City Busesand
City Council
Council only.crossed
and crossed “Motor
“Motor Tax
Tax Account”.
Account”. DO
DO NOT
NOT SEND
SEND CASH
CASH THROUGH
THROUGH THE THE POST.
POST. Contact
Contact your
your local
local Motor
Motor Tax
Tax
ADDITIONALOffice for
for clarification
clarification of
OfficeREQUIREMENTS of the
the appropriate
appropriate Motor
Motor Tax
Tax rates
rates or
or other
other payment
payment methods.
methods. Payments
Payments cancan also
also be
be made
made by
by credit
credit // debit
debit card.
card. (Motor
(Motor
Tax
Tax Rates
Rates are
are available
available on
on Aertel Page
Aertelmust
Pagebe454
454 (RTE 2) or at
at www.motortax.ie, and
and select Motor
Motor Tax Rates.)
A Certificate of Roadworthiness (CRW) in(RTE
force2)inororder
www.motortax.ie, selectTrailers,
to tax Goods Vehicles, Tax Rates.)
Buses and Ambulances over one year old.
DISCLOSURE OF DATA and aa Weight
,, and Weight Docket
Docket ifif ownership
ownership has
has changed
changed since
since itit was
was last
last taxed.
taxed.
Computer data based on this document may be subject to disclosure under Section 60 of the Finance Act, 1993 (No. 13 of 1993) as amended by Section
86 of the Finance Act, 1994 (No. 13 of 1994) and regulations made thereunder. List of disclosees is registered with the Data Protection Commissioner -
REF 721/A
WARNING - FALSE DECLARATIONS
Any person making a false declaration, or who subsequently fails to notify any changes in the licensing particulars now furnished, including disposal of the
vehicle is liable to heavy penalties. A licensing authority may require appropriate evidence as to the accuracy of particulars declared.
NOTE: AN IRISH VERSION OF THIS FORM IS ALSO AVAILABLE AT MOTOR TAX OFFICES AND GARDA STATIONS.