Get VA LES 022A 2018-2023

REQUEST FOR EXAMINATION OF REPAIRED OR REBUILT SALVAGE VEHICLE Purpose Instructions LES 022A 09/25/2013 Use this form to request an examination of a repaired or rebuilt salvage vehicle. Vehicle must be repaired/rebuilt painting is optional prior to submitting a request for examination* Complete this form make a copy for your records and submit the original* Check the appropriate title in Documents/Fees section and send the necessary documents and fees to Vehicle Branding Work Center VBWC at the address above. A DMV Law Enforcement Agent will contact you to arrange an appointment to examine the vehicle. If the vehicle passes the examination you will receive a new title by mail* If your vehicle does not pass the examination or you fail to keep your scheduled appointment you must request a new examination submit a new LES 22A and pay the necessary fees. If you have questions about requesting an examination contact DMVDirect at 804 497-7100 or visit www. dmvNow. com/Vehicle Services/All/Salvage and Non-repairable Vehicles. NOTE You must be licensed as a rebuilder to have two or more salvage vehicles examined within a 12 month consecutive period. DOCUMENTS/FEES FOR EXAMINATION CHECK THE TITLE YOU HAVE FOR THE VEHICLE* SUBMIT THE TITLE THE INDICATED FORMS AND FEES TO VEHICLE BRANDING WORK CENTER Virginia Salvage Title in your name submit completed LES 22A Title Fee - 10 Exam Fee - 125. Bill of Sale 4 Sales Tax or minimum 75 whichever is greater Title Fee - 10 Exam Fee - 125. Out-of-State Salvage Title Properly Assigned submit completed LES 22A Salvage Certificate Application VSA 56 4 sales tax or minimum 75 whichever is greater proof of sales tax paid in other state Title Fee - 10 Exam Fee - 125 insurance company appraisal or independent appraisal* Original Out-of-State Salvage Title in your name submit completed LES 22A Salvage Certificate Application VSA 56 HAVE THESE ITEMS AVAILABLE FOR THE AGENT AT THE TIME OF THE EXAMINATION Copy of completed LES 22A Photo of vehicle prior to repair/rebuilding Receipts non-repairable certificates or titles to vehicles for parts used in repairing or rebuilding Any old parts containing/displaying a VIN number REQUESTER INFORMATION INDIVIDUAL/COMPANY NAME print - last first middle suffix DRIVER LICENSE/FEIN NUMBER STREET ADDRESS no P. O. box TELEPHONE NUMBER VEHICLE LOCATION ADDRESS address where vehicle can be inspected - if different from above LICENSED REBUILDER YEAR VEHICLE BODY TYPE 2D 4D SUV PICKUP VAN MC RV TRAILER REPAIRED VEHICLE COLOR NUMBER OF AXLES PARTS REPAIRED/REPLACED REPLACED OTHER explain TRACTOR TRUCK PUBLIC VIN NUMBER EXPIRATION DATE VEHICLE INFORMATION MAKE/MODEL EMAIL ADDRESS REBUILDER LICENSE NUMBER Front Bumper Right Fender Left Rear Quarter Panel Engine Grill Left Front Door Right Rear Quarter Panel Transmission Hood Right Front Door Trunk Frame/Unibody Radiator Support Left Rear Door Rear Bumper Air Bags Left Fender Right Rear Door Roof Dash P/U Cab NOTE If you replace the pickup cab or frame you must submit a VSA 22 Application for Assigned Vehicle Identification Number.