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VSA‑22 Application for Assigned Vehicle Identification Number (Fillable PDF)

  1. Language English
  2. Country USA
  3. Activity Vehicle Registration
  4. State Virginia
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VSA‑22 Application for Assigned Vehicle Identification Number (Fillable PDF)

What Is the VSA‑22 Form?

The VSA‑22 is the Virginia Department of Motor Vehicles (DMV) application used to request an assigned vehicle identification number (VIN). It is required for homemade trailers, custom‑built vehicles, and any vehicle that does not already have a DMV‑assigned VIN.

How to Fill Out VSA‑22 Online with Formize

Instead of downloading the PDF and editing it in a separate program, you can complete the form directly on our site. Follow the simple steps below and the Formize PDF Filler will load the fillable document in your browser.

  • Step 1 – Open the Form: Click the "Fill out this form" button on this page.
  • Step 2 – Load the PDF: The Formize PDF Filler app loads the VSA‑22 PDF automatically.
  • Step 3 – Enter Your Information: Fill in vehicle details, owner information, and the reason for the VIN request.
  • Step 4 – Sign & Date: Use your mouse or touch screen to add a digital signature and date.
  • Step 5 – Download or Email: Save the completed form as a PDF or email it directly to the Virginia DMV.

Common Mistakes to Avoid

Even a small error can delay processing. Make sure you:

  • Enter the exact vehicle make, model, and construction date.
  • Provide a complete mailing address for the owner and co‑owner.
  • Check the correct box for the reason you need a VIN (e.g., homemade trailer, custom build).
  • Attach the required supporting documents, such as receipts for materials or a builder’s affidavit.
  • Sign in the Applicant Certification section and, if applicable, have a law‑enforcement officer sign the VIN installation certification.

Where to Submit the Completed Form

After you have saved the filled PDF, mail it to:

Virginia Department of Motor Vehicles
P. O. Box 27412
Richmond, VA 23269-7412
United States

Include any required fees and supporting documentation. The DMV will assign a VIN and send you a VIN plate to install on your vehicle.

FAQs About the VSA‑22 Application

Below are the most frequently asked questions about the VSA‑22 form.

FAQ
  • Who needs to file a VSA‑22 form?

    Anyone who builds a homemade trailer, custom vehicle, or any vehicle that does not already have a DMV‑issued VIN must submit a VSA‑22 to obtain an assigned VIN.

  • Can I use the VSA‑22 for a used vehicle?

    No. The VSA‑22 is only for vehicles that lack an assigned VIN, such as homemade trailers or custom‑built cars.

  • What supporting documents are required?

    Typically you need receipts for materials, a builder’s affidavit, and, if applicable, a law‑enforcement officer’s certification of the installed VIN.

  • How much is the fee for a VSA‑22 application?

    The fee varies by vehicle type; check the Virginia DMV fee schedule or contact your local DMV office for the current amount.

  • How long does it take to receive the assigned VIN?

    Processing usually takes 7‑10 business days after the DMV receives the completed form and all required documents.

  • Do I need to notarize the VSA‑22 form?

    Notarization is not required, but the VIN installation certification must be signed by a Virginia law‑enforcement officer.

  • Can I submit the VSA‑22 online instead of by mail?

    Virginia DMV currently requires the completed form and supporting documents to be mailed. However, you can fill out the PDF online using Formize before printing and mailing.

  • What happens if I make a mistake on the form?

    Incorrect or incomplete information can delay processing. Correct any errors before submitting, or contact the DMV for guidance.

HOW TO

How to fill out VSA-22 form for free, online in 5 easy steps:

  1. 1
    Open the Fillable Form
    Click the "Fill out this form" button on this page to launch the Formize PDF Filler.
  2. 2
    Load the VSA‑22 PDF
    The Formize app automatically loads the VSA‑22 PDF from the Virginia DMV.
  3. 3
    Enter All Required Information
    Fill in vehicle details, owner data, and the reason for the VIN request using the on‑screen fields.
  4. 4
    Add Your Digital Signature
    Use your mouse, trackpad, or touchscreen to sign the Applicant Certification section.
  5. 5
    Save or Email the Completed Form
    Download the finished PDF to your computer or email it directly to the Virginia DMV address.
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ABOUT

Vehicle Registration Forms

VSA-22 form is one of Vehicle registration forms that are documents used to register a motor vehicle with the relevant government authority, typically the Department of Motor Vehicles (DMV) or equivalent agency. These forms are required when a person purchases a new or used vehicle, transfers ownership of a vehicle, or moves to a new jurisdiction with a vehicle.

The specific vehicle registration forms can vary by jurisdiction, but they generally require the following information:

Vehicle Information: This includes details about the vehicle, such as the make, model, year, vehicle identification number (VIN), and odometer reading.

Owner Information: The form will require information about the vehicle's owner, including their name, address, contact information, and driver's license number.

Proof of Ownership: Depending on the circumstances, proof of ownership may be required, such as a title certificate, bill of sale, or manufacturer's certificate of origin (for new vehicles).

Insurance Information: Proof of valid vehicle insurance coverage is typically required. This may include providing the insurance policy number, dates of coverage, and insurance company details.

Payment of Fees: Vehicle registration involves payment of various fees, such as registration fees, taxes, and possibly other charges specific to the jurisdiction.

In addition to these basic requirements, some jurisdictions may have additional forms or documentation requirements. For example, emissions test results, safety inspections, or proof of residency might be necessary in certain areas.

Once the vehicle registration forms are completed and submitted, the government authority will issue a registration certificate, license plates, and registration stickers. These documents indicate that the vehicle is legally registered and authorized to be operated on public roads.

It is important to note that vehicle registration requirements can vary significantly by jurisdiction. Therefore, it is recommended to consult the local DMV or equivalent agency for the specific forms and procedures applicable to your location.

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