Vehicle modifications application for Dapth

Vehicle modifications application
This form will take approximately 5 - 15 minutes depending on how many modifications are being made to your vehicle. You will only need to complete the section relevant to you.

To help prepare you, you will require your drivers licence number and VIN or Chassis number of the vehicle.

This form covers modification associated to the engine and driveline, suspension, wheels and tyres, brakes, body, chassis, seating and lighting, and any other modifications.

Please provide as much information as possible so Department of Transport can succcessfully process your application. If you have not provided us with enough information to successfully review your request, your request will not be be approved.

You only need to complete the sections relevant to you. Questions marked with an (*) need to be completed.
Owner's details
Title*
Full name*

First nameLast name
Contact number type*
Contact mobile number*
Please enter a valid phone number. If using a landline, please include the area code.
Contact landline number*
Please enter a valid phone number. If using a landline, please include the area code.
Email*
example@example.com
Address*

Street address

Street address line 2

CityState

Postcode
Driver's licence number*
Is an agent filling in this form on the owner's behalf?*

YesNo
Agent details
Name

First nameLast name
Contact phone number*
Please enter a valid phone number. If using a landline, please include the area code.
Email
example@example.com
Address

Street address

Street address line 2

CityState

Postcode

Vehicle modification details
Important

You must complete all of the following sections with information related to the vehicle modifications you wish to undertake. Failure to complete the relevant sections and provide details of modifications may mean your application cannot be assessed.

Other modifications
Describe any other modifications that are proposed but may not have been fully explained by the questions in this form.

0/2000
Who will be performing these modifications?*

I will be performing all of the modifications myself.I will be performing some of the modifications myself.I will not be performing the modifications myself.The modifications have already been performed by someone else.
For any given modification, please specify the name of any business of other person to be commission including contact details.*

If a motor vehicle repairs business please supply Motor Vehicle Repairer's Number. If a tradesperson who holds a Motor Vehicle Repairer's Certificate please supply the Certificate (MR) number and class of repair work.0/2000

Authorisation

This section must be completed by the owner of the vehicle or the agent applying on behalf of the owner of the vehicle.
It is important the vehicle owner understands that they are responsible for the accuracy of the information presented on this form regardless of the persons they may have had assist them to complete it.

If you have not provided us with enough information to successfully review your request, your request will not be approved.
Declaration*

I declare that I am the owner of the vehicle, or the authorised agent as specified above, and I am responsible for the information provided, and that this information is true and correct.
Please verify that you are human*
Should be Empty:

Vehicle modifications application

Owner's details

Agent details

Original manufacturer's vehicle specification

Vehicle modification details

Engine, transmission, differential and exhaust system

Engine

Transmission

Differential

Exhaust system

Suspension, wheels and tyres

Vehicle height

Front suspension

Rear suspension

Front tyres

Rear tyres

Front wheel rims

Rear wheel rims

Wheel track

Steering

Brakes

Body, chassis, seating and lighting

Chassis

Seating

Seatbelts

Body

Lighting

Other modifications

Authorisation