Get IL 522 2759 2007-2024

MOTORIST INFORMATION and VEHICLE STATUS FORM Please complete this form and mail to Illinois Environmental Protection Agency Vehicle Emissions Test Program 1021 N. Grand Ave. East Springfield IL 62794-9275 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 217-524-5084 or sent by overnight service. Registered owner Street address City State Daytime telephone number Drivers license number area code Zip Model Year Vehicle Make Illinois license plate number 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 Repossessed Given away on month 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 vehicle s location i*e* tax utility tuition bill city state zip Give date when vehicle will return month year I Moved out of the test area* Give address where the vehicle is located* Visit the Secretary of State at www. cyberdriveillinois. com to change your address Out of State Compliance Certificate. Attach a copy of the passing Vehicle Inspection Report I certify this information is true and correct to the best of my knowledge and belief* Date IL 522 2759 VIM 150 10-2007 Signature of Registered Owner. East Springfield IL 62794-9275 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 217-524-5084 or sent by overnight service. Registered owner Street address City State Daytime telephone number Drivers license number area code Zip Model Year Vehicle Make Illinois license plate number Vehicle Identification Number Check one box in this column that applies to your situation I no longer own this vehicle. gov or faxed to 217-524-5084 or sent by overnight service. Registered owner Street address City State Daytime telephone number Drivers license number area code Zip Model Year Vehicle Make Illinois license plate number 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 Repossessed Given away on month 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 vehicle s location i*e* tax utility tuition bill city state zip Give date when vehicle will return month year I Moved out of the test area* Give address where the vehicle is located* Visit the Secretary of State at www. It was Sold Traded Junked Repossessed Given away on month 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 vehicle s location i*e* tax utility tuition bill city state zip Give date when vehicle will return month year I Moved out of the test area* Give address where the vehicle is located* Visit the Secretary of State at www. cyberdriveillinois. com to change your address Out of State Compliance Certificate. Attach a copy of the passing Vehicle Inspection Report I certify this information is true and correct to the best of my knowledge and belief* Date IL 522 2759 VIM 150 10-2007 Signature of Registered Owner. .