5/20/24, 12:36 PM Uganda Revenue Authority - View Motor Vehicle Print Form

Motor Vehicle Application Form

Form
This form is to be filled by any person applying for; the registration re-registration, MV-7001
alterations to registers particulars of a motor vehicle, duplicate registration plates or log
book and transfer of ownership.

Please answer in CAPITAL letters where applicable and sign the declaration. For reference, Toll Free Number
see Instruction notes on the last page. If you have any query regarding any of the questions 0800117000
consult the URA tax office.

Section A: Applicant / Transferee Details

1) Are you registering the motor vehicle / trailer / engineering plant in the name of an individual? NO (Fill part 3 and
continue with part 4) YES (Fill part 2 and continue from part 4)
2) Name of Applicant (Individual): (In case of a minor, only details of the Guardian should be provided.)
a) Title (Optional) b) Surname/Maiden Name c) First Name d) Middle Name
MR BUWEMBO IBRAHIM -
e) Acquired Name (If Different from Surname) f) Family/Father's Surname (If Different from Surname)
- -
h) Date of Birth Day Month Year
g) Sex/Gender Male Female 1 0 / 1 0 / 1 9 9 0
3) Name of Applicant (Non Individual): -
4) Do you have a TIN? No(Fill part 3) Yes(if yes, provide TIN ) 1 0 0 4 2 1 4 9 4 8
5) Address in Uganda (This must be a permanent physical address. Complete boxes( a) to (h) that apply)
a) Plot Number b) Street Name c) Building Name
- - -
d) Trading Center e) District/City f) County/Municipality
NANSANA WAKISO NANSANA MUNICIPALITY
g) Sub-County/Town Council/Division h) Village/Local Council/Zone
NANSANA DIVISION KAZO WARD,KAZO CENTRAL I

Section B: Purpose of the application

Indicate the purpose of the application by ticking the appropriate box below. Note, the application should be for one vehicle and
for one purpose.
Alteration to
First time Transfer of
Re registration registered Duplicate De registration
registration ownership
particulars
1. Motor vehicle
2. Motor cycle
3. Trailer
4. Tricycle
5. Engineering Plant

Section C: Duplicates
1. Duplicate for: Registration number plates Duplicate registration book
2. Indicate the reason for the duplicate by ticking the appropriate box below:
Stolen Lost Destroyed

Others, specify -
3. In case the log book or number plate was stolen, lost or destroyed, was the matter a) Date reported to Police
reported to Police? Day/Month/Year
/ /
No Yes (If yes, give details)

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5/20/24, 12:36 PM Uganda Revenue Authority - View Motor Vehicle Print Form

b) Name of police station c) Police Reference Number:

- -
4. Provide details of the vehicle below:
a) Registration number plates b) Registration Book Number
- -
c) Name of present registered owner d) TIN of present Registered Owner
- -

Section D: Particulars of the Vehicle

If the purpose of the application is transfer or duplicate, fill in details from no. 3 to 27 otherwise for registration and re
registration, fill in fields 1 to 27.
1) Are you applying to register (or reregister) a used vehicle? No Yes If yes, fill in the following details
(a) Previous Registration number UBD988L
Day/Month/Year
(b) Date of Previous Registration
0 5 / 0 6 / 2 0 1 8
(c) Country of registration UGANDA
2) (a) Indicate the category of number plates you are applying for: Personalized Ordinary
(b) In case of Personalized Number Plates, specify your preference: -
3. Make of vehicle 4. Manufacturer's model 5. Country of origin
TOYOTA LANDCRUISER HZJ76R-RKMRS-A2 JAPAN
6. Fees classification 7. Description of the body 8. Colour
1 Station Wagon WHITE
9. Year of manufacture 10. Attachments * Nil / Side Car 11. Fuel
2017 Nil Diesel
12. Power (cubic capacity) 13. Engine Number 14. Chassis Number
4164 1HZ0886242 JTEEB71J107039537
15. Net Weight (in Kgs) 16. Gross Weight (Laden)( in Kgs) 17. Weight system used if not metric
2180 2580 0
18. Size of tyres 19. Number of wheels 20. Number of axles
7.50R16 4 2
21. Seating Capacity 22. Purpose / Function 23. Category of Ownership
10 PRIVATE UGANDAN
24. Tax Category 25. Classification of vehicle 26. Insurance Company
1 Motor Cars - Salons,Estates,Station -
Wagons and Sedan Cars
27. Insurance * Policy / Cover Note No.
-

Section E: Declaration and Certification

I / we declare that the information given on this application is true and correct
and that failure to provide correct information may result in delayed
processing or rejection of this application or prosecution (If this form is signed by Received by:
a person other than the applicant, formal powers of attorney will be required. In the case of
a transfer, the transferee should fill in Number 2)
1. First Name Last Name Office

Signature Date: Day/Month/Year Name

/ /
2. First Name(Transferee) Last Name Signature

Signature Date: Day/Month/Year Date Day/Month/Year

/ / / /

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