Test form SK File Drop files here or Select files Max. file size: 32 MB. OwnerThis field is hidden when viewing the formDate MM slash DD slash YYYY Unique IDThis field is hidden when viewing the formExaminer NameNessPalenServiceMichaudBelzevickThis field is hidden when viewing the formCompleted Date MM slash DD slash YYYY This field is hidden when viewing the formNot Assigned, for just cause Not Assigned, for just cause This field is hidden when viewing the formNew VIN NumberThis field is hidden when viewing the formControl NumberCompany Name- OR -Last Name of Owner*First Name of Owner*Middle Name of OwnerAddress* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Driver's License NumberHome Phone Number*Additional Phone NumberEmail* Vehicle / Trailer InformationYear*Make*Model*Colour*BeigeBlackBlueBronzeBrownBurgundyCopperCreamDark BlueDark GreenGoldGreenGreyLight BlueLight GreenMaroonNot AvailableOrangeOtherPinkPurpleRedSilverTanTurquoiseWhiteYellowVehicle Style*Choose Your Vehicle StyleSingle Axle Trailers ($175 + GST & PST)All motor vehicles and Tandem Axle Trailers ($500 + GST & PST)MileageLicence Plate Number (if available)Original VIN (if available)Is this a Home Built Trailer? Yes No Vehicle / Trailer LocationWhere is the vehicle located? Same as Mailing Address Vehicle Location Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Reasons for the Assigned VIN ApplicationPlease check the reason(s) for the Assigned VIN Application VIN Lost Door Replaced Dashboard Replaced Theft Recovery VIN Illegible VIN Removed Modified Amalgamated Home-built / Ubilt Kit Car Cab swap or cab replacement Glider Kit Other Other SpecifyComponentsIs the vehicle home-built, ubilt, amalgamated, rebuilt, or containing major components that are not from the original vehicle?* Yes No Only complete this section if the vehicle is home-built, ubilt, amalgamated, rebuilt, or contains major components that are not from the original vehicle. Present the original invoices to VVS at the time of the vehicle / trailer examination. VVS will make copies or take digital pictures of the invoices for retention.EngineEngine SupplierEngine Purchase Date MM slash DD slash YYYY Engine Source Vehicle VINTransmissionTransmission SupplierTransmission Purchase Date MM slash DD slash YYYY Transmission Source Vehicle VINCab (Truck)Cab SupplierCab Purchase Date MM slash DD slash YYYY Cab Source Vehicle VINDash BoardDashboard SupplierDashboard Purchase Date MM slash DD slash YYYY Dashboard Source Vehicle VINChassis FrameChassis Frame SupplierChassis Frame Purchase Date MM slash DD slash YYYY Chassis Frame Source Vehicle VINPaymentTotal Cost Price: Total Cost Price: This field is hidden when viewing the formGST (single)This field is hidden when viewing the formPST (single)This field is hidden when viewing the formGST (all vehicles)This field is hidden when viewing the formPST (all vehicles)Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20252026202720282029203020312032203320342035203620372038203920402041204220432044 Expiration Date Security Code Cardholder Name Acknowledgement* I acknowledge that the information collected by VVS will be disclosed to SGI for the purpose of the administration of Saskatchewan's VIN assignment program. Invoice Total$194.25$555.00Include invoice total here for non-payment form.
