HomeMy WebLinkAboutApplication for Duplicate Certificate of Registration TREASURY DIVISION OFFICIAL USE ONLY
COUNTY OF HAWAII
101 PAUAHI STREET,SUITE 5
HILO,HAWAII 96720-4224
• WEM icetbn adept a u Irate Iseu
Date-Clerk
TYPEWRITE OR PRINT IN INK-Improperly filled application will not be accepted.
License Plate Number. Registration Expiration -FEE
Make: Emblem Number. $W 0
a
Vehicle IdentificationNumber.
Registered Owner of Record:
Address:
NUMBER AND STREET CITY ZIP CODE
The undersigned certifies that the Certificate of Registration for the above described vehicle has
been F-1 lost F]stolen F]mutilated F1 defaced, and hereby requests the issuance of
duplicate,which issuance shall void the original certificate.
DEFACED OR
MUTILATED
CERTIFICATE MUST SIGNATURE OF REGISTEREDOWNER OF RECORD
BE SURRENDERED
WITH THIS
APPLICATION IF FIRM,PRINT NAME AND TITLE OF PERSON SIGNING
.. . ........ .., Harm Carty Is an EQuel Oppaurtty Pmwkiw vW Empbyer ow-1101d