Form 78-9891E "International Registration Plan (Frp) Irp (2) - Vehicle Information" - New Brunswick, Canada

ADVERTISEMENT
ADVERTISEMENT

Download Form 78-9891E "International Registration Plan (Frp) Irp (2) - Vehicle Information" - New Brunswick, Canada

Download PDF

Fill PDF online

Rate (4.6 / 5) 13 votes
Reset
INTERNATIONAL REGISTRATON PLAN (FRP)
PLEASE PRINT OR TYPE
78-9891E (12/14)
IRP (2) – VEHICLE INFORMATION
PAGE ___OF ___
Vehicle Transaction Type Code (TRANS CD)
Vehicle Types (VEH TYPE)
Fuel Type
(1) Client ID
Fleet
YY
Supp
(2) Registrant name
AV – Add Vehicle
AR – Add Vehicle using Credit
TK – Truck
TT – Truck Tractor
D - Diesel
P - Propane
BS - Bus
DV – Delete Vehicle
DR – Delete Vehicle using Credit
G – Gasoline
O - Other
Vehicles listed on this page will be authorized to operate in all jurisdictions
at the weights listed below. Use additional page(s) for any vehicle with a
weight difference in any jurisdiction.
TRANS CD
UNIT No.
PLATE#
PROV
NEW PLATE#
Year
Make
Model
Colour
CYL
FUEL
VEH
VEHICLE IDENTIFICATION NUMBER
TYPE
NOTE: If weight varies 10% in jurisdictions, please explain:
1
INSURER’S NAME
____________________________________________________
BUS SEATS
WHEEL BASE
TARE (kg)
AXLES
INSURANCE POLICY NUMBER
EXPIRY DATE
(m)
____________________________________________________
LESSOR/NAME
LESSOR ADDRESS
CANADA
(KGS)
U.S
(LBS)
BROKER NAME
BROKER ADDRESS
.
OWNED VEH. – DATE OF PURSHASE
BC
MD
MONTHLY LEASE AMOUNT
LEASE START DATE
LEASE END DATE
PURCHASE PRICE
TRADE-IN VALUE
$
$
$
AB
ME
SK
MI
TRANS CD
UNIT No.
PLATE#
PROV
NEW PLATE#
Year
Make
Model
Colour
CYL
FUEL
VEH
VEHICLE IDENTIFICATION NUMBER
MB
MN
TYPE
ON
MO
2
INSURER’S NAME
BUS SEATS
WHEEL BASE
TARE (kg)
AXLES
INSURANCE POLICY NUMBER
EXPIRY DATE
QC (axles)
MS
(m)
NB
MT
LESSOR/NAME
LESSOR ADDRESS
NS
NC
BROKER NAME
BROKER ADDRESS
PE
ND
OWNED VEH. – DATE OF PURSHASE
MONTHLY LEASE AMOUNT
LEASE START DATE
LEASE END DATE
PURCHASE PRICE
TRADE-IN VALUE
NL
NE
$
$
$
YT
NH
NT
NJ
TRANS CD
UNIT No.
PLATE#
PROV
NEW PLATE#
Year
Make
Model
Colour
CYL
FUEL
VEH
VEHICLE IDENTIFICATION NUMBER
U.S.
(LBS)
NM
TYPE
AK
NV
3
INSURER’S NAME
BUS SEATS
WHEEL BASE
TARE (kg)
AXLES
INSURANCE POLICY NUMBER
EXPIRY DATE
AL
NY
(m)
AR
OH
LESSOR/NAME
LESSOR ADDRESS
AZ
OK
BROKER NAME
BROKER ADDRESS
CA
OR
OWNED VEH. – DATE OF PURSHASE
MONTHLY LEASE AMOUNT
LEASE START DATE
LEASE END DATE
PURCHASE PRICE
TRADE-IN VALUE
CO
PA
$
$
$
CT
RI
DC
SC
TRANS CD
UNIT No.
PLATE#
PROV
NEW PLATE#
Year
Make
Model
Colour
CYL
FUEL
VEH
VEHICLE IDENTIFICATION NUMBER
DE
SD
TYPE
4
FL
TN
INSURER’S NAME
BUS SEATS
WHEEL BASE
TARE (kg)
AXLES
INSURANCE POLICY NUMBER
EXPIRY DATE
GA
TX
(m)
IA
UT
LESSOR/NAME
LESSOR ADDRESS
ID
VA
BROKER NAME
BROKER ADDRESS
IL
VT
OWNED VEH. – DATE OF PURSHASE
MONTHLY LEASE AMOUNT
LEASE START DATE
LEASE END DATE
PURCHASE PRICE
TRADE-IN VALUE
IN
WA
$
$
$
KS
WI
KY
WV
LA
WY
SIGNATURE OF APPLICANT
APPLICANT NAME (PLEASE PRINT)
DATE
MA
MAIL TO: IRP Office, PO Box 1998, Fredericton NB E3B 5H4 or fax to: (506)453-3076
Reset
INTERNATIONAL REGISTRATON PLAN (FRP)
PLEASE PRINT OR TYPE
78-9891E (12/14)
IRP (2) – VEHICLE INFORMATION
PAGE ___OF ___
Vehicle Transaction Type Code (TRANS CD)
Vehicle Types (VEH TYPE)
Fuel Type
(1) Client ID
Fleet
YY
Supp
(2) Registrant name
AV – Add Vehicle
AR – Add Vehicle using Credit
TK – Truck
TT – Truck Tractor
D - Diesel
P - Propane
BS - Bus
DV – Delete Vehicle
DR – Delete Vehicle using Credit
G – Gasoline
O - Other
Vehicles listed on this page will be authorized to operate in all jurisdictions
at the weights listed below. Use additional page(s) for any vehicle with a
weight difference in any jurisdiction.
TRANS CD
UNIT No.
PLATE#
PROV
NEW PLATE#
Year
Make
Model
Colour
CYL
FUEL
VEH
VEHICLE IDENTIFICATION NUMBER
TYPE
NOTE: If weight varies 10% in jurisdictions, please explain:
1
INSURER’S NAME
____________________________________________________
BUS SEATS
WHEEL BASE
TARE (kg)
AXLES
INSURANCE POLICY NUMBER
EXPIRY DATE
(m)
____________________________________________________
LESSOR/NAME
LESSOR ADDRESS
CANADA
(KGS)
U.S
(LBS)
BROKER NAME
BROKER ADDRESS
.
OWNED VEH. – DATE OF PURSHASE
BC
MD
MONTHLY LEASE AMOUNT
LEASE START DATE
LEASE END DATE
PURCHASE PRICE
TRADE-IN VALUE
$
$
$
AB
ME
SK
MI
TRANS CD
UNIT No.
PLATE#
PROV
NEW PLATE#
Year
Make
Model
Colour
CYL
FUEL
VEH
VEHICLE IDENTIFICATION NUMBER
MB
MN
TYPE
ON
MO
2
INSURER’S NAME
BUS SEATS
WHEEL BASE
TARE (kg)
AXLES
INSURANCE POLICY NUMBER
EXPIRY DATE
QC (axles)
MS
(m)
NB
MT
LESSOR/NAME
LESSOR ADDRESS
NS
NC
BROKER NAME
BROKER ADDRESS
PE
ND
OWNED VEH. – DATE OF PURSHASE
MONTHLY LEASE AMOUNT
LEASE START DATE
LEASE END DATE
PURCHASE PRICE
TRADE-IN VALUE
NL
NE
$
$
$
YT
NH
NT
NJ
TRANS CD
UNIT No.
PLATE#
PROV
NEW PLATE#
Year
Make
Model
Colour
CYL
FUEL
VEH
VEHICLE IDENTIFICATION NUMBER
U.S.
(LBS)
NM
TYPE
AK
NV
3
INSURER’S NAME
BUS SEATS
WHEEL BASE
TARE (kg)
AXLES
INSURANCE POLICY NUMBER
EXPIRY DATE
AL
NY
(m)
AR
OH
LESSOR/NAME
LESSOR ADDRESS
AZ
OK
BROKER NAME
BROKER ADDRESS
CA
OR
OWNED VEH. – DATE OF PURSHASE
MONTHLY LEASE AMOUNT
LEASE START DATE
LEASE END DATE
PURCHASE PRICE
TRADE-IN VALUE
CO
PA
$
$
$
CT
RI
DC
SC
TRANS CD
UNIT No.
PLATE#
PROV
NEW PLATE#
Year
Make
Model
Colour
CYL
FUEL
VEH
VEHICLE IDENTIFICATION NUMBER
DE
SD
TYPE
4
FL
TN
INSURER’S NAME
BUS SEATS
WHEEL BASE
TARE (kg)
AXLES
INSURANCE POLICY NUMBER
EXPIRY DATE
GA
TX
(m)
IA
UT
LESSOR/NAME
LESSOR ADDRESS
ID
VA
BROKER NAME
BROKER ADDRESS
IL
VT
OWNED VEH. – DATE OF PURSHASE
MONTHLY LEASE AMOUNT
LEASE START DATE
LEASE END DATE
PURCHASE PRICE
TRADE-IN VALUE
IN
WA
$
$
$
KS
WI
KY
WV
LA
WY
SIGNATURE OF APPLICANT
APPLICANT NAME (PLEASE PRINT)
DATE
MA
MAIL TO: IRP Office, PO Box 1998, Fredericton NB E3B 5H4 or fax to: (506)453-3076
INSTRUCTIONS
The following instructions are intended to provide general directions on completion of your application. Please review carefully prior to submitting your forms. Print or type all information entered on the application form.
If you have any questions contact the IRP office in your area. Further information is provided in the IRP Carrier Manual. Completed forms
may be faxed to begin the application process; however original signed copies of the form must be submitted to IRP office.
1. CARRIER ACCOUNT INFORMATION
Client ID No.
The seven (7) digit account number assigned to you by the IRP office. If you are a new carrier, leave this space blank.
Fleet
The two (2) digit Fleet number.
Fleet Year
The last two (2) digits of the year in which the fleet expires. For example if your fleet expires March 31, 2010 the year is 10.
Supp
The three (3) digit supplement number for the application. A first transaction or fleet renewal in IRP is supplement 00. If you do not know the supplement number, leave this
space blank.
2. REGISTRANT NAME
Enter the name of the Carrier, person, Company or corporation in which the fleet is to be registered.
3. WEIGHT VARIANCES
IPR limits the registered weight to not vary by more than 10% between the highest and lowest weights requested for jurisdictions. If the weight varies more than 10% within Canada or 10% within US, you must provide a detailed explanation in the space provided.
4. VEHICLE WEIGHTS
List Canadian jurisdiction weights in Kilograms (for Quebec the number of axles) and US weight in pounds. Weights must be entered for all jurisdictions.
5.VECHICLE INFORMATION
TRANS CD
UNIT NUMBER
CURRENT PLATE #
AV
Add Vehicle
New fleet, renew fleet and add
Carrier Assigned Unit Number for vehicle within fleet
Plate number currently on vehicle
vehicle to fleet
DV
Delete Vehicle
Delete vehicle without
replacement in same
supplement
AR
Add Vehicle (credit)
Add vehicle using credit from
deleted vehicle in same
supplement
DR
Delete vehicle (credit)
Delete vehicle using credit on
fees for another vehicle within
same supplement
PROV
2 Digit Provincial code in which vehicle is registered.
NEW PLATE #
Leave Blank For Office Use Only
YEAR
Year of Vehicle
MAKE
MODEL
COLOUR
Up to first six (6) digits of make
Up to first six(6) digits of model of vehicle
Primary COLOUR of vehicle
CYL
Number of cylinders
FUEL
Fuel type as listed by code on vehicle information form
VEH TYPE
The type of vehicle as per vehicle types listed on form.
VEHICLE IDENTIFICATION
Complete VIN (serial number) of vehicle being registered.
BUS SEATS/ WHEEL BASE
Maximum number of passengers that can be transported / wheel
TARE WEIGHT
Empty weight of power unit.
NUMBER (VIN)
base in meters.
INSURER’S NAME
AXLES
Number of axles on power unit
INSURANCE POLICY
Policy number issued by insurance company
Name of Insurance Company
NUMBER
EXPIRY DATE
Expiry date of insurance policy in DD/MM/YYYY format
LESSOR/BROKER NAME
Complete name and address of lessor or broker
MONTHLY LEASE AMT
Lease amount per month in Canadian funds
AND ADDRESS
LEASE START/END DATE
Starting and Ending dates of lead in DD/MM/YYYY format
OWNED VEHICLE DATE OF
Date vehicle purchased in DD/MM/YYYY format
OWNED VEHICLE
Purchase price of vehicle in Canadian funds, including accessories,
PURCHASE
PURCHASE PRICE
service and finance charges
TRADE IN VALUE
Value of Trade in on previous vehicle in Canadian $
6. SIGNATURE
Signed and dated by contact person
NOTE: The Issuance of a Registration Document Is Not a Wavier of the Requirements for Any IRP Jurisdiction with Respect to Obtaining Operating Authority, Fuel Permits, Numbers or Financial Responsibility
Page of 2