Vehicle Registration Transfer Application - Queensland State
Part B. Proof of Transfer/Notice of Disposal: Seller to keep.
Vehicle details
Registration/Plate number Expiry date
/ /
Privacy Statement - The department is collecting the information on this form for the
purposes of maintaining the department's vehicle registration register, as required under
the Transport Operations (Road Use Management) Act 1995. Where required, the
department or its agents/contractors may give some or all of this information to vehicle
insurers, statutory entities, insolvency entities, lawyers, persons involved in vehicle
incidents/accidents, vehicle manufacturers, third parties who are involved in or intend to
commence various legal proceedings, tolling entities, law enforcement agencies and to or
through interstate registering authorities. Your personal information will not be disclosed to
any other third party without your consent, unless authorised or required to do so by law.
Sellers Copy
Vehicle Registration Transfer Application
Transport Operations (Road Use Management) Act 1995
1
10
Disposers name
2 The vehicle is to be transferred from
:
Note: If registered in joint names all disposers details must be
completed below.
First Disposers details
Disposers Customer Reference Number (CRN)
Disposer's name
Second Disposers details (if applicable)
Disposers CRN
/ /
Qld Safety/Qld Inspection Certificate number Issue date
Full name
/ /
6
9
Acquirer/s signature/s
/ /
Disposer/s signature/s - if currently in joint names the
signature of only one Disposer is required
Date
/ /
Date
Acquirer's identification details
As the Disposer of this vehicle, you must positively identify
the person who will now be responsible for the vehicle.
Postcode
First Registered operators details
Full name and residential/business address
Postal address (if same as above write AS ABOVE)
Postcode
Does the above individual or organisation have a CRN?
No
Complete a New Customer Application (F3503)
Yes
CRN
The registered operator above is (tick one box)
Is the vehicle to be transferred into two names?
No Yes
3
4
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WARNING: If you reasonably believe the Acquirer has not applied for transfer of the vehicles registration within 14
days, you may lodge the Sellers Copy AND a copy of the Qld Safety or Qld Inspection Certificate with the department.
You may be held responsible for offences committed by the Acquirer/s until their details are recorded with the
department.
The CRN is your Qld Driver Licence number, Adult Proof of Age Card number
or your reference number issued by the department.
Second registered operators details
No
Complete a New Customer Application (F3503)
Yes
CRN
5
Qld Safety OR Qld Inspection Certificate details
(if applicable)
It is an offence to give false or misleading information under
the Transport Operations (Road Use Management) Act 1995.
Maximum penalty may exceed $6000.
Private individual/s
Registered company
Other/legal entities
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Business/trust
You must nominate one
proprietor/trustee of the business or
trust as the second registered operator.
Date of disposal
7
8
Current Odometer (Speedo) reading (if applicable)
Declaration
All Acquirer/s must sign, however, future transactions will
require only one signature. I/We declare that the information
provided is correct and that the true Dutiable Value has been
declared. I/We consent to the department verifying my
evidence of identity documents or information with the issuing
authority or their agencies.
Vehicle Registration Dutiable Value
What is the Dutiable Value
(including GST)
for this
vehicle at the date of disposal?
Dutiable Value is defined on the
Information Sheet of this form.
$
Part B Page 5 of 5 TRB Forms Area Form F3520 V01 Jul 2014
Page 5/5
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