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Get Illinois Air Team Waiver Form

Illinois Environmental Protection Agency Bureau of Air 1021 North Grand Avenue East P. O. Box 19506 Springfield Illinois 62794-9506 Motorist Information and Vehicle Status Form Please complete this form and mail to Vehicle Emissions Test Program P. O. Box 767 Elk Grove Village IL 60009-0767 All requested information MUST be provided and a registered owner must sign this form or it will NOT be processed* For faster service this form may be e-mailed to epa*vim2528 illinois. gov or faxed to 847 758-3420 or sent by overnight service. Registered owner Street address City State Zip Daytime telephone number area code Illinois license plate number Model Year Vehicle Make Vehicle Identification Number Check one box in this column that applies to your situation I no longer own this vehicle. It was Sold Traded Junked On month Repossessed Given Away year This vehicle is out of the area* Give address where vehicle is located and date of return* If The vehicle cannot comply prior to the Registration Expiration Date provide proof of the out of area location i*e* tax utility tuition bill Full address of Vehicle Location must be on Proof* Give date when vehicle will return month Out of State Compliance Certificate. Attach a copy of the passing Vehicle Inspection Report State where test was conducted If you have moved visit www. cyberdriveillinois. com and change your address on your Registration and DL with the Office of the Secretary of State. I certify this information is true and correct to the best of my knowledge and belief* Date Signature of Registered Owner IL 522 2759 VIM 150 8/2015 E-mail Address. O. Box 767 Elk Grove Village IL 60009-0767 All requested information MUST be provided and a registered owner must sign this form or it will NOT be processed* For faster service this form may be e-mailed to epa*vim2528 illinois. gov or faxed to 847 758-3420 or sent by overnight service. Registered owner Street address City State Zip Daytime telephone number area code Illinois license plate number Model Year Vehicle Make Vehicle Identification Number Check one box in this column that applies to your situation I no longer own this vehicle. gov or faxed to 847 758-3420 or sent by overnight service. Registered owner Street address City State Zip Daytime telephone number area code Illinois license plate number Model Year Vehicle Make Vehicle Identification Number Check one box in this column that applies to your situation I no longer own this vehicle. It was Sold Traded Junked On month Repossessed Given Away year This vehicle is out of the area* Give address where vehicle is located and date of return* If The vehicle cannot comply prior to the Registration Expiration Date provide proof of the out of area location i*e* tax utility tuition bill Full address of Vehicle Location must be on Proof* Give date when vehicle will return month Out of State Compliance Certificate. It was Sold Traded Junked On month Repossessed Given Away year This vehicle is out of the area* Give address where vehicle is located and date of return* If The vehicle cannot comply prior to the Registration Expiration Date provide proof of the out of area location i*e* tax utility tuition bill Full address of Vehicle Location must be on Proof* Give date when vehicle will return month Out of State Compliance Certificate. Attach a copy of the passing Vehicle Inspection Report State where test was conducted If you have moved visit www..

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