LTO FORM NO.

•
REPUBLIC OF THE PHILIPPINES
DEPARTMENT OF TRANSPORTATION
LAND TRANSPORTATION OFFICE
East Avenue, Quezon City
TO: MV INSPECTOR - THIS FORM WILL BE USED AS A
SOURCE DOCUMENT IN COMPUTERIZATION. FILL
MOTOR VEHICLE
UP COMPLETELY AND ACCURATELY IN INK. INSPECTION REPORT MVIR NO.
OWNERSHIP AND DOCUMENTATION
OWNER'S COMPLETE NAME AND ADDRESS AGENCY DATE

AUTHORIZED AGENCY (For hire only) FILE NUMBER

ACQUIRED FROM (Complete Name and Address) TYPE OF REGISTRATION

D 1. NEW 02. RENEWAL D 3. OTHERS (Specify)
MVRR NUMBER (Latest) CHPG CONTROL NUMBER

ENCUMBRANCE (Complete Name and Address) CERT. OF PAYMENT NUMBER (C.P.) ~

INFORMAL ENTRY NUMBER (I.E.)

INSURER: .........,
POLICY NUMBER

KIND OF VEHICLE
D 1. NEW D 4. CAR D 7. MC 9. OTHERS (Specify)
EXPIRY DATE: I CERT. OF COVER NO. ENDORSEMENT NO

Cl 2. 2ND HAND Cl 5. TRUCK DATE OF ENDORSEMENT: AMOUNT PL TPL

D 3. REBUILT 0 6. HIRE D 6. TC OF
COVERAGE p p
1 HEREBY CERTIFY THAT ALL

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I N FORMATION ANO THC
STENCIL BELOW ARE TRUE
ANO CORRECT. INSPECToR·s PRINTED NAME & SIGNATURE
IDENTIFICATION AND INSPECTION
CLASSIFICATION
I MAKE PLATE NO.

·-
TYPE OF FUEL
o GAS o CNG
MOTOR NUMBER
,......
SERIAUCHASSIS NUMBER Cl DIESEL 0 ELECTRIC
CJ LPG 0 OTHERS
SERIES I TYPE OF BODY COLOR NO. OF DOOR I YR. MODEL I TOTAL PISTON DISPLACEMENT (cuJcm.) 1 NO. CYL

BODY 0 1 SAFE 0 2. UNSAFE 0 3. DILAPIDATED Cl RADIO Cl YELPER Cl SPARE TIRE D EWO

' ACCESSORIES
0 cs Cl AJRCON 0 TOOLS 0 BATIERY
OOORIWlNDOW 01 GOOO 0 2. LOOSE D 3. UNSAFE
DRIVE D AUTOMATIC 0 POWER DOVER 0 CONVENTIONAL
WINDSHIELD

CAPACITY
MARKING
CJ 1. GOOO

Cl 1 COMPLETE
0 2. DEFECTIVE

D 2. INCOMPLETE
D 3. NONE

0 3. INACCURATE O 4. NONE
MAX HEIGtff MAx.LENGTH MAX.WIDTH I OVERHANG EXCESS
OVERHANG
l WHEELBASE

FRONT SEAT NO. OF AXLE SIZE OF TIRES KIND OF TIRES

APPEARANCE Cl 1. NEAT Cl 2. FAIR 03 UNSIGHTLY
FRONT I REAR FRONT
IREAR
CHASSIS CJ 1. GOOD CJ 2. UNSAFE
T GROSS WEIGHT WEIGHT EMPTY SHIPPING WEIGHT
R c
SPRING CJ 1. GOOD D 2. UNSAFE D 3. WEAK
" 0 4. LOOSE
u A
c NET WEIGHT PASS. CAPACITY R PASS. CAPACITY
SEAT D 1. NEAT Cl 2. FAIR 0 3. WORN OUT K

BATTERY 0 1. GOOD D 2. DEFECTNE D 3. LEAKING I HEREBY CERTIFY THAT ALL

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INFORMATION CONTAINED
FUEL TANK 0 1. GOOD HEREIN ARE TRU E AND
0 2. LEAKING 0 3. UNSAFE
CORRECT. INSPECTOR'S PRINTED NAME & SIGNATURE
OPERATION AND SAFETY TEST
REFRIGERANT Cl 1. R134A CJ 2. OTHERS AIRCON Cl 1. EQUIPPED CJ 2. NOT APPLICABLE
TYPE

ENGINE D 1. NEAT 0 2. FAIR CJ a. DIRTY CLUTCH 0 1. GOOD CJ 2. DEFECTIVE 0 3. LOOSE

SYSTEM

HEAD LIGHTS 0 1. COMPLETE 0 2. NO DIMMER 0 3. GLARING HORN Cl 1. STANDARD 0 2. DEFECTIVE Cl 3. ILLEGAL

FOOT
STOPLIGHT Cl I. GOOD 0 2. OEFECTNE 0 3. NONE
BRAKE
0 1. GOOD 0 2. DEFECTIVE a 3. LOOSE

PARK LIGHT 0 1. GOOD 0 2. DEFECTNE Cl 3. NONE HAND 0 1. GOOD D 2. DEFECTIVE 0 3. LOOSE

BRAKE

SIGNAL LIGHTS D 1. GOOD D 2. DEFECTIVE CJ 3. NONE PANEL

GAUGES 0 1. GOOD Cl 2. DEFECTIVE 0 3. COMPLETE 0 4. INCOMPLETE

INTERIOR 0 1. GOOD 0 •. DEFECTIVE CJ 3. INCOMPLETE SMOKE 0 1. NORMAL 0 2. SMOKE BELCHER

LIGHTS EMISSION

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DIMMER '
D 1. GOOD 0 2. DEFECTIVE 0 3. NONE
SWITCH ' ""''"' CERTIN
INFORMATION ""' ANO
ARE TRUE "-'
CORRECT AND THAT AN ACTUAL
TIRES 0 1, GOOD 0 2. WORN OUT 0 3. UNSAFE 0 4. SPARE TEST WAS CONDUCTED. INSPECTOR'S PRINTED NAME & SIGNATURE

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WHEELS 0 1. NORMAL 0 2. UNSAFE 0 3. WOBBLY 0 4. UNALIGNED CHIEF INSPECTOR/TDS
DAPPROVED
STEERING 0 1. NORMAL CJ 2. STIFF 0 3. LOOSE 0 4 UNSAFE D DISAPPROVED

WIPER D 1. GOOD D 2. DEFECTIVE D 3. NONE BY: TOO PRINTED NAME & SIGNATURE

MOTOR NO. STENCIL HERE CHASSIS/SERIAL/BODY NUMBER STENCIL HERE

 CHECKLIST
MANDATORY SUPPORTING DOCUMENTS
FOR REGISTRATION TRANSACTIONS
PRIVATE
I. New Registration
1. lmpe>tted Mt>tor Vehicle
0 Original Invoice
0 Certification of Payment of
taxes
0 CSR
0 CHPG clearance
O Insurance Certificate of Cover
0 Actual inspection of Motor
Vehicle & duly accomplished
MVIR (stencils of motor &
chassis nos. must be done on
the space provided for)
0 Early Warning Device (EWD)
2. Locally Assemble/Rebuilt
0 CSR
O Original Sales Invoice/Commercial
Invoice of motor/chassis
0 CR & OR of motor/chassis,
if taken from another motor
vehicle
O Certification of Payment of
Taxes from Boe BOC & BIR, if
motor/chassis are imported.
0 CHPG clearance
0 Insurance Certificate of Cover
O Affidavit of Rebuilt of Owner/
Mechanic
O Actual Inspection of Motor
Vehicle & duly accomplished
MVIR (stencils of motor &
chassis nos. must be done on
the space provided for)
O Early Warning Device (EWD)
II. Renewal of MV Registration
O Original copy of Registration
Certificate
0 Original copy of current
official receipt of payment
0 Insurance Certificate of Cover
O Actual Inspection of Motor
Vehicle & duly accomplished
0 MVIR (stencils of motor &
chassis nos. must be done on
the space provided for)
O Early Warning Device (EWD)
Ill. Transfer of Ownership
O Original copy of Registration
Certificate
0 Original copy of current
official receipt of payment
O Original copy of Deed of
Sales/Transfer
0 CHPG clearance
O Insurance Certificate of Cover
O Confirmation of Registration
Certificate (Cir. No. 123)
O Board of Resolution of Secretary's
certificate if the vendor/
Transferor is a corporation
0 Actual inspection of Motor
Vehicle & duly accomplished
MVIR (stencils of motor &
chassis nos. must be done on
the space provided for)
IV. Duplicate Registration Certificate
[J Affidavit of Loss for Registration
Certificate
O Clearance from law/Enforcement
Service, C.O./AO
O Actual Inspection of Motor
Vehicle &duly accomplished
MVIR (stencils of motor &
chassis nos. must be done on
the space provided for)
EVALUATOR'S PRINTED NAME & SIGNATURE
v Annotation of Mortgage
0 Original copy of Registration
Certificate
O Original copy of current
official receipt of payment
D Copy of Deed of Chattel Mortgage
duly stamped received by
the Register of Deeds
D Actual Inspection of Motor
Vehicle &duly accomplished
MVIR (stencils of motor &
chassis nos. must be done on
the space provided for)
VI. Cancellation of Mortgage
D Original copy of Registration
Certificate (CRE)
D Original copy of current
official receipt of payment
0 Release of Chattel Mortgage
duly stamped received by
the Register of Deeds
0 Actual Inspection of Motor
Vehicle & duly accomplished
MVIR (stencils of motor &
chassis nos. must be done on
the space provided for)
VII. Change Motor/Chassis/Color/Body
Design
D Original copy of Registration
Certificate
0 Original copy of current
official receipt of payment
0 Original copy of Invoice
0 CSR
0 Affidavit of change chassis/
motor/body/color
0 CHPG clearance
o Insurance Certificate of Cover/
lndorsement from insurance
Company
O Actual Inspection of Motor
Vehicle & duly accomplished
MVIR (stencils of motor &
chassis nos. must be done on
the space provided for)
Note: Change chassis of For
Hire Motor Vehicles are
Considered rebuilt.
VIII. Duplicate Plates/Stickers
O Original copy of Registration
Certificate
D Original copy of current
official receipt of payment
0 Affidavit of Loss
0 Clearance from Law
Enforcement Service, C.0.
D Actual Inspection of Motor
Vehicle & duly accomplished
MVIR (stencils of motor &
chassis nos. must be done on
the space provided for)
IX. Storage
O Original copy of Registration
Certificate
D Original copy of current
official receipt of payment
D Pair of motor vehicle plates.•
(*To be surrendered to the LTO)
x. Re-stamping of Engine/Chassis
Numbers
D Original copy of Registration
Certificate
O Original copy of current
official receipt of payment
O PCL Recommendation
D PC Physical Investigation Report
0 Affidavit of owner and mechanic
stating the reason/s or
need for re-stamping
0 Investigation Report of the TIFS
and/or TOO
XI. Sheriff Sale
0 Original copy of Registration
Certificate
0 Original copy of the current
official receipt of payment
D Original copy of sheriff's
Certificate of Sale
0 Authenticated copy of the
Sheriff's Return
0 Confirmation of the Court
that rendered judgement
0 Copy of the Court's decision
and Writ of Execution ordering
the sale of public auction
0 Duplicate copy of chattel
mortgage contract duly stamped
received by the Register of Deeds
O CHPG clearance
Insurance Certificate of Cover
0 Actual Inspection of Motor
Vehicle & duly accomplished
MVIR (stencils of motor &
chassis nos. must be done on
the space provided for)
FOR HIRE MOTOR VEHICLES
" For Hire" - (PUJ, PUB, TX MCH)
O Confirmation of franchise from the
Records section, LTFRB/R.0.
LTFRB
0 Latest CR & OR
0 Insurance Certificate of Cover
D BIR payment of Common Carrier
Tax
0 CHPG clearance
0 CSR
0 Original Sales lnvoice/s
0 Imported motor/chassis-confirmation
of Payment of TS)(es from
BOC& BIR
O Affidavit of change motor/chassis
executed by owner and mechanic
0 Actual Inspection of Motor
Vehicle & duly accomplished
MVIR (stencils of motor &
chassis nos. must be done on
the space provided for)
0 Early Warning Device (EWD)
COMPUTATION FEES
Registration Fee _ _ __ ~ ----
Plate/Sticker
Science
Penalties
LRF
Miscellaneous
Transfer
Change Engine/Chassis/
Color/Body/Design
Others
TOTAL ~ ----
COMPUTER'S PRINTED NAME & SIGNATURE