ANSMA Historic Vehicle Registration (Renewal)

Purple & White Plates - see image above (plate letter may vary)

Is Your Plate Purple & White ending with letters G,H,J,K or L?

YesNo

Please click the link here to the Classic Registration Renewal form Classic Registration Renewal Form

You will need your pink slip & details to complete the Historic Vehicle Declaration fields for ANSMA to sign & stamp. Don't attach the brake test receipt.

If the member details are not confirmed checked you have typed all lower case. Then if your email address has NOT been found in the ANSMA database. Please contact admin@ansma.com.au for assistance.

Note: Enter your email address in lower case only (no capitals) to match the records in the ANSMA database (eg youremail@abc.com)

Enter your ANSMA email address

Email Address*

Member Number*

Member First Name*

Member Last Name*

The fields below will complete your HISTORIC VEHICLE DECLARATION form and sends us a PDF for us to sign and stamp. Do NOT send us another copy of your Historic Declaration

You cannot use your ANSMA membership to register vehicles under another persons name. If the surname and given name below does not match your member name above, your application will be denied.

Drivers licence / Customer number*

Surname*

Must match member surname above

Given Names*

Must match member first name above

Address Line 1*

eg 45 Smith Street

Address Line 2*

eg Baulkham Hills

Post Code*

State*

Club Membership Details*

Plate number*

(if known)

VIN or chassis/frame or serial number*

Engine number*

Make*

Model year*

Model*

(in full - name, letters and/or numbers, variant)

Shape*

Vehicle Type*

Safety Inspection report number*

Safety Inspection report date *

Date

Upload Pink Slip*

Browse Files

DO NOT COVER PINK SLIP WITH A RECEIPT. Do NOT attach BRAKE TEST receipt. File must be LESS than 10mb (10,000Kb)

Postage Processing Payment*

Postage Processing$10.00AUD

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Once your payment is received we will send you confirmation of receipt of your paperwork.

Thank you!

Historic Vehicle "Renewal" Form

Registered operator details

Vehicle details