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Get Dmv-54-vt Rev 05/12 West Virginia Department Of Transportation Division Of Motor Vehicles

Nt/Owner(s) Information Applicant s Name Name(s) on Registration Street Address STATE CITY ZIP B) B) Vehicle Vehicle Information Information Year Make Title No. Current Plate No. VIN No. C) Insurance Information Effective Dates of Policy From: / / To: / / Policy No. Insurance Company NAIC Number Insurance Agent D) Applicant Certification I certify that all information on this application is true and correct and if I cease to be in good standing with the above organization, I wi.

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