MSVA1 Application form - Application for a Minister's Approval by qvg16642

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									 Motorcycle Single Vehicle Approval (MSVA)
 Application for a Minister’s Approval Certificate
 Motor Cycles etc. (Single Vehicle Approval) Regulations 2003

 MSVA1 (July 2010)
 Please read the notes on pages 3 and 4 before completing your application. Failure to complete
 the form accurately or in full may cause a delay.
 * For official use only                                                       * NR

 1. Vehicle Identification Number (in full) :
 This information, VIN, frame or chassis number is likely to be found on the manufacturer’s data plate located on the frame or,
 in the case of car based vehicles, under the bonnet or around the door aperture. Where the number is considered to be
 inadequate, you will be referred to your DVLA Local Office for them to allocate a suitable number.
 2. Vehicle make :                                                    Vehicle Model :

 3.     a) Vehicle Type : (please tick appropriately)                           Moped              Low powered moped
        Please see page 3 for definitions of types.                         Motorcycle             Motorcycle & sidecar
                                                                                                            Motor tricycle
                                                                     Light quadricycle                Heavy quadricycle
        b) Is the vehicle designed to carry goods?                                                        Yes             No
        c) Number of wheels (moped ONLY) :                                                                    2             3
        d) Which side of the vehicle is the sidecar on (motorcycle & sidecar ONLY)? :                   Right           Left

 4. Vehicle category :                                                   Amateur Built                              Rebuilt
                                                        Vehicle manufactured using parts of a registered vehicle
 Please see page 3 for definitions. If none applies, please leave blank.

 5. Is the vehicle built from a kit? :                                                                  Yes               No
       Is it a special / custom vehicle built from the ground up? :                                     Yes               No

 6. Where would you like the vehicle tested?                       First choice :
                                                             Second choice :
 Please provide a second choice of Test Station as the first may not be available. Some Stations can only carry out tests on
 certain vehicle types. Please refer to the list on page 4 for details. N.B. Retests must be carried out at the same station as the
 original test.

 7. When would you like the test? :
 8. At what time would you like the test? :
 You will be given an appointment as near to your choice as possible. Out of hours testing may be available at certain Test
 Stations. This will be before 8am or after 5pm on a Monday to Thursday, before 8am or after 4.30pm on a Friday or any time
 on a Saturday, Sunday or Bank Holiday. A supplementary fee is payable for testing outside normal working hours.

 9. Payment Method : You will be contacted by telephone for Debit / Credit card payments.

 Cheque          Postal        Credit or                              Cash                            Pre-funded
                 Order         Debit card         (ONLY when application is presented in person)      account

 10.                               Contact Name :
                Company Name (if applicable) :
         Applicant’s UK address or address to
       which appointment letter is to be sent :
             Please ensure details are entered in
                    full and include the Post Code                                        Postcode :
                                Contact Numbers : Tel :                                   Fax :
                                  Email Address :



VOSA 33 (July 2010)                                            1                                                            MSVA1
 11. Does the vehicle have full bodywork?                                                                  Yes               No
 A bodied vehicle is defined as ‘a vehicle with a structure consisting/comprising of a floor plan and panels, which with a roof, fully
 encloses the vehicle occupants and without a roof, encloses them other than where a roof would be’.

 12. Date of manufacture (month and year) :
 This information should be obtainable from the manufacturer’s data plate, the owner’s manual or from the manufacturer or their
 agent.

 13. Date of manufacture of engine :
 Only required for vehicles which fall into categories listed at question 4 on page 1.

 14. Engine Details :                 *Petrol 2 stroke / Petrol 4 stroke / Diesel / Other e.g. LPG, electric
                                      *Turbocharged / Non-turbocharged
     Transmission Type :              *Manual / Automatic                                                     *Delete as appropriate
                                                                            Engine Capacity :                                       cc
                                                                         Fuel Tank Capacity :                                    litres
                                               Engine / motor maximum power output :                                   bhp/PS/kW*
                                                         Maximum Power Engine Speed :                                             rpm
                                                                         Weight of batteries :                                     kg
                                                          The weight of batteries is required for electrically propelled vehicles only.

 15. Vehicle weights : Unladen Weight :                             kg           Goods Vehicle Payload :                           kg
     Gross Design Weights : (Only required for goods vehicles)
     Axle 1              kg    Axle 2              kg      Axle 3              kg    Gross               kg    Train                kg
 This information should be obtainable from the manufacturer’s data plate, the owners’ manual or from the manufacturer or their
 agent. If the vehicle is powered by an electric motor, these weights should not include the weight of the batteries.

 16. Maximum Road Speed :                                                                                                        mph
This information should be obtainable from the owner’s manual or from the manufacturer or their agent.

 17. Is the vehicle fitted with an anti-lock brake system? :                                               Yes              No
     Is the vehicle fitted with a linked braking system? :                                                 Yes              No

 Data Protection : The personal information you provide on this form will be used for the purposes of VOSA’s
 statutory functions. It will not be disclosed to other organisations unless required or permitted by law. For further
 information, visit our Information Charter available from : www.dft.gov.uk/vosa.
 DECLARATION : I declare that, to the best of my knowledge and belief, all statements in this application are true.


 Full Name : …………………………………………………. Signature : …………………………………………………..

 Date : …………………………………………………………

 Please ensure that this declaration is signed. Failure to do so will result in a rejection of your application.
 WARNING : Any person who knowingly or recklessly makes a false statement is liable on conviction to a heavy
 penalty (see Section 174(2) of the Road Traffic Act 1988).
 On Completion : Please send your application, together with the appropriate fee* to the test station of your choice
 (please see list on page 4). Cheques and postal orders should be crossed and made payable to ‘VOSA’. Please
 do not send notes, coins or Giro transfers in the post. For details on customer accounts, please contact any test
 station or call the VOSA National Number on 0300 123 9000.
 *Check websites below for current MSVA fees information.
 For Further Information :
  Visit the following websites : www.dft.gov.uk/vosa & www.direct.gov.uk/msva.
  Call the VOSA National Number on 0300 123 9000.
   (Calls provided by BT are charged at a low rate. Charges from other providers may vary.)




VOSA 33 (July 2010)                                            2                                                              MSVA1
   Definitions of Vehicle Types :
   Mopeds
   Low powered moped
         a moped with pedals,
         with auxiliary propulsion not exceeding 1kW, and
         a maximum design speed not exceeding 25km/h (16mph).
   2 wheeled vehicle
         with a maximum design speed not exceeding 45km/h (28mph) (48km/h [30mph] if manufactured before 08/0/03),
         fitted with an internal combustion engine having a cylinder capacity not exceeding 50cc, or
         fitted with an electric motor with a maximum continuous power not exceeding 4kW.
   3 wheeled vehicle
         with a maximum design speed not exceeding 45km/h (28mph) (48km/h [30mph] if manufactured before 08/08/03),
         fitted with a spark ignition combustion engine having a cylinder capacity not exceeding 50cc, or
         fitted with any other internal combustion engine which has a maximum net power output not exceeding 4kW, or
         fitted with an electrical motor with a maximum continuous power not exceeding 4kW,
         not exceeding 270kg unladen, and
         if designed to carry goods, a payload not exceeding 300kg.
   4 wheeled vehicle (light quadricycle)
         with a maximum design speed not exceeding 45km/h (28mph) (48km/h [30mph] if manufactured before 08/08/03),
         fitted with a spark ignition internal combustion engine having a cylinder capacity not exceeding 50cc, or
         fitted with any other internal combustion engine which has a maximum net power output not exceeding 4kW, or
         fitted with an electrical motor with a maximum continuous power not exceeding 4kW,
         not exceeding 350kg unladen, and
         if designed to carry goods, a payload not exceeding 200kg.
   If any of the above moped classes are powered by an electric motor, the weight of the batteries must not be included in
   the unladen weight. A vehicle fitted with an electrical motor with a maximum continuous power of more than 4kW will be
   classed as a Motorcycle or a Motor Tricycle as appropriate.
   Motorcycles
   2 wheeled vehicle
        with or without sidecar,
        fitted with an internal combustion engine having a cylinder capacity of more than 50cc and/or a maximum design
         speed of more than 45km/h (28mph). Includes electrically powered vehicles
   Motor Tricycles
   3 wheeled vehicle (with 3 symmetrically arranged wheels)
        fitted with an internal combustion engine having a cylinder capacity of more than 50cc and/or a maximum design
         speed of more than 45km/h (28mph). Includes electrically powered vehicles.
        not exceeding 1000kg unladen, and
        if designed to carry goods, a payload not exceeding1500kg.
   4 wheeled vehicle (heavy quadricycle)
        fitted with an internal combustion engine having a cylinder capacity of more than 50cc and/or a maximum design
         speed of more than 45km/h (28mph),
        the maximum net power not exceeding 15kW,
        not exceeding 400kg unladen (550kg for goods vehicles), and
        if designed to carry goods, a payload not exceeding 1000kg,
        the weight of the batteries not being included in the unladen weight.
   Definitions of Vehicle Categories :
   Amateur Built Vehicle :
   A vehicle constructed or assembled :
        for the personal use of the applicant,
        by the applicant, or by individuals acting on behalf and under the direction of the applicant,
        by persons not in the business in which motor vehicles are normally constructed or assembled.
   Rebuilt Vehicle :
   A vehicle which :
        is not an amateur built vehicle within the meaning given above and is not a vehicle manufactured using parts of a
          registered vehicle within the meaning given below,
        has been rebuilt using a replacement chassis, or an integral chassis body, which was supplied for the purpose
          without having been previously used or previously formed part of a registered vehicle,
        is of the same design and construction as the original vehicle.
   Vehicle manufactured using parts of a registered vehicle :
   A vehicle constructed or assembled :
        by a person carrying on a business in the course of which motor vehicles are normally constructed or assembled,
        using a previously used engine and one or more of the following components taken from the same previously
          registered vehicle : chassis or frame, body, suspension, a braked axle with more than one wheel, transmission, or
          steering assembly.




VOSA 33 (July 2010)                                         3                                                           MSVA1
   MSVA TEST STATIONS – Telephone the VOSA National Number on 0300 123 9000 for transferral to a Station.

   N.B. - Testing of 2 wheeled vehicles is available at stations marked B. Testing of 3 wheeled vehicles is
   available at stations marked T and testing of 4 wheeled vehicles is available at stations marked Q.
   ● Aberdeen (B) - Cloverhill Road, Bridge of Don Industrial Estate, Aberdeen, AB23 8FE.
   ●Beverley (B/T/Q) - Oldbeck Road, Off Grovehill Road, Beverley, East Yorkshire, HU17 0JW.
   ●Birmingham (Garretts Green) (T/Q) - Garretts Green Industrial Estate, Birmingham, B33 0SS.
   ●Birmingham (B) - Unit 10, Elmdon Trading Estate, Birmingham, B37 7HE.
   ●Bristol (Avonmouth) (B/T/Q) - Merebank Road, Bristol, BS11 8AQ.
   ●Cardiff (Llantrisant) (B/T/Q) - School Road, Miskin, Pontyclun, CF72 8YR.
   ●Carlisle (B/T/Q) - Brunthill Road, Kingstown Industrial Estate, Carlisle, Cumbria, CA3 0EH.
   ●Chelmsford (B/Q) - Widford Industrial Estate, Chelmsford, Essex, CM1 3DR.
   ●Derby (B/T/Q) – Belmore Way, Alvaston, Derby, DE21 7AY.
   ●Exeter (B/T/Q) - Grace Road, Marsh Barton Trading Estate, Exeter, Devon, EX2 8PU.
   ●Gillingham (B/T/Q) - Ambley Road, Gillingham, Kent, ME8 0SJ.
   ●Glasgow (B/T/Q) - Crosshill Road, Bishopbriggs, Glasgow, G64 2QA.
   ●Leighton Buzzard (B/T/Q) - Stanbridge Road, Leighton Buzzard, Bedfordshire, LU7 4QG.
   ●Liverpool (B) - Stopgate Lane, Simonswood, Kirby, Liverpool, L33 4YA.
   ●London South (Mitcham) (B/T/Q) - Redhouse Road, Croydon, Surrey, CR0 3AQ.
   ●London West (Yeading) (T/Q) - Cygnet Way, Willow Tree Lane, Yeading, Hayes, Middlesex, UB4 9BS.
   ●Manchester North (Chadderton) (B/T/Q) - Broadway Business Park, Broadgate, Chadderton, Oldham,
    OL9 9XA.
   ●Newcastle (B/T/Q) - Sandy Lane, Gosforth, Newcastle upon Tyne, NE3 5HB.
   ●Norwich (B/T/Q) - Jupiter Road, Hellesden, Norwich, NR6 6SS.
   ●Southampton (Northam) (B/T/Q) - Unit R, Centurion Industrial Estate, Bitterne Road West,
    Southampton, SO18 1UB.
   ●Watford (B) - Unit A, Caxton Court, Caxton Way, Watford, WD18 8RH.

   MSVA does not apply to the following vehicles :
    Vehicles over ten years old.
    Vehicles with a maximum design speed not exceeding 6km/h.
    Cycles with pedal assistance which are equipped with an auxiliary electric motor having a maximum
     continuously rated power of 0.25kW, of which the output is progressively reduced and finally cut off as the
     vehicle reaches a speed of 25km/h or sooner, if the cyclist stops pedalling.
    Vehicles intended for pedestrian control.
    Trial or enduro motorcycles intended for use in competitions, on roads or whatever the terrain.
           Trial Motorcycles are defined as having the following characteristics :
              a) maximum seat height of 700mm,
              b) minimum ground clearance of 280mm, and
              c) maximum fuel tank capacity of 4 litres.
           Enduro Motorcycles are defined as having the following characteristics :
              a) minimum seat height of 900mm, and
              b) minimum ground clearance of 310mm.
    Agricultural tractors, off road tractors, agricultural engines or light agricultural vehicles, as defined below.
           Agricultural Tractor – a tractor used on public road solely for purposes relating to agriculture,
           horticulture, forestry or activities falling within :
              a) cutting verges bordering public roads;
              b) cutting hedges or trees bordering public roads or bordering verges which border public roads.
           Off Road Tractor – a tractor which is not an agricultural tractor and which is :
              a) designed and constructed primarily for use other than on roads, and
              b) incapable by reason of its construction of exceeding a speed of 25mph on the level under its
                  own power.
           Agricultural Engine – a machine specially designed/converted to perform an agricultural operation on
           the land (e.g. a combine harvester).
           Light Agricultural Vehicle – a vehicle which :
              a) has a revenue weight not exceeding 1000kg,
              b) is designed and constructed so as to seat only the driver,
              c) is designed and constructed primarily for use other than on roads, and
              d) is used solely for purposes relating to agriculture, horticulture or forestry.
    Vehicles designed primarily for off-road leisure use, having wheels arranged symmetrically with one
     wheel at the front and two at the rear.
    Vehicles adapted or constructed to enable use by a disabled person (i.e. a person who has a disability as
     defined in Section 1 of the Disability Discrimination Act), whether as driver or passenger.



VOSA 33 (July 2010)                                      4                                                        MSVA1

								
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