Workshop Presentation
Contents
1. APPLICATION FOR TEXAS TITLE TYPE OR PRINT NEATLY IN INK _ TAX OFFICE USE ONLY Standard Presumplive Value 2T3YFREVOFW168445 TOYOTA 8 Odometer Reading iens 12 This is fhe Actual mileage unless one of the foliawing is checked 13 For comected tie check reason s Make Body Sila Model Change in Vehicle Description Jan Year dd Lien Other Odometer Reading Odomneter Brand 14 Applicant x Business Gevemment Trust Non Profit First Applicant Cwner Photo 10 Number or FEIWEIN 15 12345678 _ State Terran _ _ Country i HATO n Cher Military Status af Forces Photo ID U S Citienship Immigration Server DO ID US Depariment of State ID U S Department of Homeland Security ID 6 anuCwmar Legal Name eal Lam any smith 17 Owner County of Residence Tarrant Suffoc d Car World i Fort Worth _ 21 Renewal Recipient Mame if diferent First Middie Last Sufix if any 22 Renewal Mailing Address diferent Al 23 Vehicle Location Address different State Cannot check 20 Ach Farm WTR 267 Zip 76115 30 Check oniy if applicable MOTOR VEHICLE TAX STATEMENT hold Motor Vehicle Fretader s Rental Permit and wil satisfy the minimum tax liability V A T S Tax Code 5152 048 c lam a dealer ce lessor and qualify to take2. AIRCHECKTEXAS DRIVE A CLEAN MACHINE PROGRAM Auto Dealer Workshops August 2016 Robby Sprosty Air Quality Analyst Trey Pope Air Quality Analyst North Central Texas Council of Governments AIRCHECKTEXAS DRIVE A CLEAN MACHINE Vehicle Repair and Replacement Program Help qualifying participants repair or replace vehicles that do not pass emissions inspection or are 10 or more years old Target the highest polluting vehicles and allows citizens to contribute to the regional air quality solution 6 from emissions inspection fee from 1996 and newer vehicles Texas Commission on Environmental Quality TCEQ funds approximately 20 million annually to North Central Texas counties for repair and replacement assistance Provide up to 600 for repair or up to 3 500 for replacement assistance i Drive a AirCheckTexas Clean Machine AIRCHECKTEXAS DRIVE A CLEAN MACHINE Vehicle Repair and Replacement Program Statistics Since Inception January 2002 July 2015 Vehicles retired through Program 30 948 Funds paid to dealers from Program 91 450 118 Average Replacement Vehicle Cost 18 875 Number of Participating Auto Dealers FY 2015 226 High Emitting Vehicles Repaired 31 659 s Drivea AirCheckTexas Clean Machine 3 AIRCHECKTEXAS DRIVE A CLEAN MACHINE Participation Requirements Texas Department of Motor Vehicles TxDMV Licensed Motor Vehicle Dealer Read and follow the dealer
3. ITUTIOM CREDIT TERMS ARE ACCEPTED PULL DEPOSIT D LIEN AUAILABEL HCHASER AGREEMENT Tw IS CP LEGAL AGE IN THE STATE 27 AIRCHECKTEXAS DRIVE A CLEAN MACHINE 5 Order Summary Participant name and address information on this form must match same information on voucher letter f address changes provide proof of new address If last name changes provide proof of new name Replacement vehicle being purchased year make model and VIN must match information provided on back of voucher Voucher amount 3 000 or 3 500 listed as trade in sales tax calculations will be checked Vehicle sales price must meet program guidelines Purchase date must be within voucher issued date and expiration date dates shown before voucher issued or after expiration date will NOT be reimbursed Participant and dealer must sign and date Enter all information correctly so staff can verify the vehicle meets reguirements and proceed with document review ncorrect missing info will result in delayed reimbursement N AIRCHECKTEXAS DRIVE A CLEAN MACHINE Title Application APPLICATION FOR TEXAS TITLE TYPE OR PRINT NEATLY IN INK Standard Presumplwe Value Remove Lien Oter Odometer Reading Bx individual Gevemmem _ Trust Non Profit First ApplicantiOwner Photo ID Number or FEIWEIN 15 10 4115 Driver s License Card 12345678 Tear Passport
4. Buyer is the same person s as the Participant Name s printed on the voucher letter If needed ensure name appears in the Co signensY printed on the voucher letter Trade in vehicle is drivable and matches Retred Vehicle Information printed on voucher letter Record all details of REPLACEMENT vehicle being purchased below before il is sold Obtain information from vehicle Year Drive ZWDI4WD Fuel Typo Undernood ID Model Test of Cylinders Odometer Transmission i i Vehick qualifies for program compare detads above against eligible vehicles list at www nclcog ora airrchecktexas Odometer reading of replacement vehicle being sold is 70 000 miles or less Sales price of vehicle is 35 000 or less for Tier 2 Bin 4 or Bin 5 vehicles or 45 000 or less for Tier 2 Bin 3 or cleaner hybrid electric or natural gas vehicle see the STND column in the eligible vehicle list for Bin level 3 000 00 voucher value Tier 2 Bin 4 or 5 or 23 500 voucher value Tier 2 Bin 3 of cleaner hybrid electric or natural gas vehicle is listed as trade in an Buyer s Order and Title Application Line 43 6 voucher value reduces taxes owed Manifest signed and dated by participants dealer representative and dismantler Buyer s Order Bill cf Sale and Title Application signed and dated by participant s and dealer representative Trade in vehicle is marked Air heckTexas and locked and secu
5. Country _ US Military ID Other Military Status of Forces Photo ID 055 Citizenship amp Immigration ID US Depariment of State ID us Department of Hameland Security IE 163 Applicant Crwner Legal Name Body Style Model 7 Change in Vehicle Description year Odometer Brand Middle Sulfix T 17 Owner County of asidero Sui id any 1212 First Street Previa Damar Mami Burt Hara Car World Fort Worth 21 Renewal Recipient Name jf diferent 22 Renewal Maling Address different Vehicle Location Address if different 24 F rst Lien Date 25 Lienfoider Name first 25 Cens ed Lienholder ID No 27 Electronic Ti a Request iCannet check 28 09 03 2015 Bank of Texas haan gems Fer vm 2n Lienhekler Mading Address zn Stem i 123 Maple Street Fort Warth TX ce y T applicable MOTOR VEHICLE TAX STATEMENT O I haki Motor Vehicle Retailer s Rental Permil Ma and wil satisfy he minimum tax liabisty T E Tax Code 8152 046 ep a dealer or lessor and qualify to take the Fair Market Value Deduction V A T S Tax Code 8152 002 GON or Lessor Number m w 32 Additional Trade ins EN Trade in if ary Vehicle Identification Mu ata r Year Make 1FAFP34PSRM789010 1990 Taurus 33 SALES AMD USE TAX COMPUTATION a Sales Price 2000 00 rebate has been deducted s 20 101
6. status of their submitted vouchers AIRCHECKTEXAS DRIVE A CLEAN MACHINE Requirements for Voucher Reimbursement Enter voucher and replacement vehicle information into the dealer database Submit by mail or shipment Completed and signed voucher letter checklist Manifest photocopy Goldenrod copy of manifest Buyer s order itle application Vehicle Inspection Report Photocopy of participant s Driver License s Proof of address change if applicable Verification of name change if applicable Must submit all documents within 30 days of sale date Make copies of everything you send us and keep for three 3 years NEW for FY 2016 37 AIRCHECKTEXAS DRIVE A CLEAN MACHINE Surveying Participants All participants surveyed after redeeming their voucher to determine Were they treated fairly Were they charged fees to use their voucher Have they experienced problems with their replacement vehicle Should the dealership be allowed to continue participating in the AirCheckTexas Program 38 AIRCHECKTEXAS DRIVE A CLEAN MACHINE Site Visits and Monitoring Regional Administrator may conduct periodic onsite monitoring visits at participating dealer locations to ensure compliance with program rules Documentation of vehicle purchases retirement vehicle transfers account activity may be reviewed for consistent information and inspection of any retirement vehicle awaiting transfer to an appr
7. 85 50 Now Resident Tax Previous Slate b Less Tr den Amount described in Item 31 above 3 000 00 5 Even Trade Tax ic For Dealers Lessors Penal ONLY Fair Mares Value 410 Tax Llam Conmplrneller Form 14 317 Deducbon described in Rem 31 above Rebuill Sale Fez 1 id Taxable Amount fem a minus hem or Item j 17 101 85 7 25 Emissions Fee Diesel Vehiches 1996 and Cider gt 14 000 lbs 6 6 25 Tax on Taxable Amount Hem d by 0825 5 1 065 BT 1 Emissions Fee Diesel Vahidas 1997 and Newer gt 1400066 f Late Tax Payment Penalty 5 er _ 10 3 400 Tax Paid to STATE 5 0 00 ht AMOUNT OF TAX AND PENALTY DUE 4 068 387 328 or 533 Application Fee for Texas Tite sm e plus Ibsen Henn g A A a 71 Statements In This Document Are True And Correct To The Best Of My Knowledge And Bellet Exeenption claimed under the Motor Vehicle Sales and Use Tax Law because Jane Jones 09 03 2015 Printed Name Sarne as Signature Dale mmm Printed Hamels Same as Signatures Date John Smith Printed Name Same as Signature Date Peggy Smith 09 03 2015 K Fig tonal Omen Printed Namejs Same as Signatureis Date ARNING Transportation Code 8501 155 provides that falsifying information on title transfer documents is a third degree felony offense Form 130 U Rev 02 2015 i Online Form at waw TxDMV gov 76013 First H Last Sulfix f any 29 Title Application
8. above against eligible vehicles list at www nctcog org airchecktexas E Odometer reading of replacement vehicle being sold is 70 000 miles or less 12 AIRCHECKTEXAS DRIVE A CLEAN MACHINE FY 2016 Replacement Vehicle Requirements As of September 1 2015 eligible models change to 2013 2016 cars SUVs and minivans 2013 2016 hybrid electric and natural gas vehicles and Tier 2 Bin 3 or cleaner vehicles 2014 2016 trucks Sales Price Maximum after rebates dealer discounts incentives 35 000 for Tier 2 Bin 4 8 Bin 5 vehicles vehicles eligible for 3 000 voucher 45 000 for hybrid electric natural gas and Tier 2 Bin 3 or cleaner vehicles vehicles eligible for 3 500 voucher Mileage Limitation 70 000 miles or less at time of purchase Federal Tier 2 Bin 5 or cleaner emissions standards intended for everyday use not to exceed 10 000 Ib weight S DRIVE A CLEAN MACHINE Potential Locations of Underhood ID Label AIRCHECKTEXAS DRIVE A CLEAN MACHINE AIRCHECKTEXAS DRIVE A CLEAN MACHINE a y den i i ete n r A 16 AIRCHECKTEXAS DRIVE A CLEAN MACHINE 17 AIRCHECKTEXAS DRIVE A CLEAN MACHINE Verifying From Checklist to the Eligible Vehicle Lists Replacement Vehicle Details From the Checklist vin 2T3YFREVOFW168445 Fagin Dispi Year 2015 Drive 2WD 4WD 2WD TOYOTA E Fuel Type GAS UNLEADED Model RAV 4 Test Group FTYXJO2 5BEL A
9. w eEfH state TX z TxDLA Used Automotive Parts Recycling Business License Number 4i z 3 g IH l l 84 TCEQ Storm Water Permit Number T y NMVTISID Number RR elo JAMES X p 4 3 20 Sahuge Dismanting Facility Representative Veritying VINE Pacaip ot DESTRUCTION CERTIFICATION certify that the emissions control equipment AND THE ENGINE of this vehicle have been destroyed Emissions control equipment may include but is not limited te the following exhaust gas recirculation system power control module catalytic converter oxygen sensors evaporative purge canister positive crankcase ventilation valve gas cap SEE PENALTY NOTICE ON REVERSE SIDE mercury switches have been removed and also certify that the vehicle has been destroyed and the remaining residual scrap metal will be conveyed to a participating recycling facility RECEIVING RESIDUAL Scrap METAL SEE INSTRUCTIONS ON REVERSE SIDE Recycling Facility oo 0 nc A Phon amp o County Physical Address Glr lt A O Zip Scale Ticket Reference Number i TITTI RE Print Fiacycling Flecelving Residual Scrap Metal Dato While Automobile Dealership Green Automobile Daalarship I Yalow Salvage Dismaning Facility Pink dg i Facili Goldenrod Auto Dealership ho NCTEOG o ho Fk Eo 6 l
10. C h e n u m be sed by d ea to Expires After replacement vehicle purchase date must be on or before the date listed Note purchase must not take place before the voucher letter 15 issued claim in the database NOTE THE DEALER REPRESENTATIVE MUST o Expires After replacement vehicle VERIFY THAT ALL FEATURES ARE PRESENT purchase date must be on or before BEFORE ACCEPTING A VOUCHER LETTER the date listed No negotiations or purchase of vehicle may take place before the voucher letter is issued AIRCHECKTEXAS DRIVE A CLEAN MACHINE Vehicle Replacement Voucher Letter Drive a AlrCheck Texas Clean Machine s 08 4 2015 John Smith NORTH CENTRAL TEXAS REGION 1212 First Street Voucher Number TAR 08259 1 41915 Fort Worth TX 76108 Expires after 09 13 2015 Dear John amp mith You have been approved to receive replacement assistance through the AirChackTexas Drive a Clean Machine Program This approval letter qualifies you to receive 3 000 toward the purchase of a qualifying car or truck or 3 500 toward the purchase of a qualitying hybrid vehicle electric vehicle natural gas vehicle or a Tier 2 Bin or cleaner vehicle Please note the expiration date of 09 13 2015 below the voucher number on this letter This approval letter must be presentec and vehicle purchased at a participating dealership on or before the expiration date as we are unable to provide extensions due to funding awai
11. CE 17 101 85 4 8 SALESTAX AS 65 80 DURHEHT COOMETEA MEAG BALANCE GWE 10 5 Documentary Fas sre e te TOTAL DELIVERED PRIZE IF THIS ES FOR A MAMI pete OF LIGHT TIEN Wot SEE BENT FOR DANT THES AGREE PORQ ION ON THE FORM OVER RIDES ANY ODNTRARY rpg ctr eae CASH DUE CM DELIVERY 8 TRADE MALLGWAMEDE 70 UEN 11 TOTAL DOWN PAYMENT 12 BALANCE 24 AIRCHECKTEXAS DRIVE A CLEAN MACHINE 5 Order CAR WORLD 175 South Street Fort Worth TX 76109 817 556 5555 nite _ 817 555 5555 12345678 DOM FANNY First Insurance 711573223918 25 AIRCHECKTEXAS DRIVE A CLEAN MACHINE a 08 1 PRICE OF VEHICLE 2 OTHER TAXABLE CHARGES Buyer s Order 4 B SALES TAX TU E TOTAL DELIVERED PRICE 18 319 52 amp CASH DUE ON DELIVERY TRADE N ALLOWANCE 10 Loss LIEN 11 TOTAL DOWN PAYMENT 12 BALANCE 13 FINANCE CHARGE Fe 14 INSURANCE CHARGE 16 TOTAL AMOUNT OF AGREEMENT AIRCHECKTEXAS DRIVE A CLEAN MACHINE 5 Order HF THIS A USED CAR OF LIGHT TRUCK THE INFORMATION WO SEE ON TRADE C WINZChN FORM IS PART OF THES AGREE INFORMATION DIN THE WIN FORM OVERRIDES ANY ih THE CONTRACT SALE AGREEMENT IB KOT BINDING ON EITHER THE BOTH PANTIES OR SIALL NC an ACCEPTED FY ALL THE PARTIR OS ALER PLACHAGER
12. E OWNER Mame _ JOHN SMITH 511 559 5555 Date 4 3 2015 Mailing Address hit Fest 5T cay _ State _ TEXAS Zip 1601 5 VEHICLE INFORMATION Ps elm Als l t 3 E A Vehicle Identitication Number cena Plate Mumbar Odo mater Reading war 1490 FORD modo 5 coor GREY A Titis Document Number 05 TU 673123 601 q L ol Venice Car DEALERSHIP Dealership _ vw 0e Lp Phone ti 1 556 5555 County TALLANT Physical Address 18 Sour ST cay Faer WoestH state TEXAS 16 04 Mailing Address 7S SOuTH ST city FORT WORTH sue TEXAS Zip 1404 __ JANE JONES 4 3 2015 Dealership Representative Varying WIN Pooe pi of Velmcla u Dabs NOTE Payment to Automobile Dealership Contingent Upon Signature Below of Dismantler Verifying Receipt of Vehicle 21 AIRCHECKTEXAS DRIVE A CLEAN MACHINE AirCheckTexas Retired Vehicle Transfer Manifest OLE FACILIT Y SET ON To be de aut by Salvage Desmantler Hepresentative a ent Facility 165 5 months after receipt to deliver ras dual Spas metal lo a participating recycling Tac l m Salvage Dismantling Facility AUTO Prone i amp IT 557 gt FIT County TARRANT Physical Address _ ll WEST Ave City _ Fiery woes ht State TX Zip ZN Mailing Address WEST Ave cy Emer
13. IRCHECKTEXAS DRIVE A CLEAN MACHINE Dealer Checklist Summary Complete all details of vehicle being purchased Include full name of the make and model no abbreviations Test Group 15 found a Vehicle Emission Control Information label under the hood Vehicle must have 70 000 miles or less Vehicle has a current and proper inspection Safety only inspection for vehicles two years and newer Safety and emissions inspection for vehicles more than two years old Dealer to provide copy of valid passing Inspection report with paperwork Dealer representative must print sign and date bottom of page Enter all information clearly and correctly so staff can verify the vehicle is eligible for reimbursement Inconsistencies or missing information will result in delayed reimbursement AIRCHECKTEXAS DRIVE A CLEAN MACHINE AirCheckTexas Retired Vehicle Transfer Manifest AmCheckTexas RETIRED VEHICLE TRANSFER MANIFEST NT 1 U 4 9 49 Program Administrator NORTH CENTRAL TEXAS COUNCIL OF GOVERNMENTS NCTCOG Phone Toll Free BOX 5888 ARLINGTON TEXAS 76005 5888 817 608 2350 AurowosiLE DEALERSHIP SECTION be fi Venice Owner Name JOHN Sh Phone 817 555 5556 Date 4 3 2015 Mailing Addross 1212 ST cay ARLINGYDA State _ Texas Zip 16017 VEHICLE INFORMATION lelalelel3lulelslelmlalglalol lol lalslol1 213 21 19 Vehicle Id
14. document review Incorrect missing info will result in delayed reimbursement AIRCHECKTEXAS DRIVE A CLEAN MACHINE Dealer Database Main Page Login using your specific dealership username and password Main page view you DO NOT see the Search for Vouchers option then your location has not been activated to accept Replacement vouchers Logged As Example Dealer LUGDLIT Historical DRE Paid Change Password Dealer Agreement Instructions 1 Dealership representative will need to log into the AirCheckTexas Dealer Database and enter the username and password that was provided Each physical location has its own username and password For example if you have two locations then you will need to log in one location at a time and complete all these steps 2010 vehicles are no longer eligible Database Users Manual Dealer ne and Conditions You have 1 voucher s approved for payment 34 AIRCHECKTEXAS DRIVE A CLEAN MACHINE Dealer Database Main Page Main page view If you DO see the Search for Vouchers option then your location has been activated to accept Replacement vouchers Texas Automotive Dealership Logged In As Example Dealer Drive a exas Clean Machine LOGOUT Main Search for Correspondence Eligibile 2014 Vehicles 3 yme Eligible 2013 Vehicles Historical Vouchers Paid Eligible 2012 Vehicles Change Password E
15. entification Number VIN License Plate Number Odometer Reading var 1440 FORD mode TAURVS color GREY Titie Document Number 05 1 5 6 181 23 1 6014 2 Signature at Vehicla Owner DEALERSHIP Dealership _ AR woekp Phone 27 556 655 5 County TARRANT Physical Address 15 SouTH ST _ City Foex Woez1 H State TEXAS _ Zip 16 109 Mailing Address __ 1 SouTH ST s__ City FORY wo TH State TEXAS Zip 1161084 NES NEN l 1 3 1015 Dealers Representative Vertying VIN amp of Vehicle Signature NOTE Payment to Automobile Dealership Contingent Upon Signature Below of Dismantler Verifying Receipt of Vehicle Ve HICLE Ren REMENT LITY Sec ON To 1 ontns after receipt t cycling Salvage Dismantling Facility AUTO AA 6655 ig TARRANT Physical Address _ I WEST AVE Foer woer tt state T zp 1 Mailing Address ut Mi WET ANC 1 City wees en Zip NU TXDLR Used Automotive Parts Recycling Business License Number 2 3 gl 1514171891 TCEQ Storm Water Permit Number T 6 NMVTIS ID Number R 01111104 7 jm JAMES 7 Iams ge iE 3 Salvage Salvage Dismarfing Facility Representative Veritying VIN amp Receipt of Vehicle mme and LEA certify that the emissions control equipment AND THE ENGINE of this vehicle have been destroyed Emissions control equipment may include bu
16. lability Retired Vehicle Information Participant Name s Eligible Co signer s 1990 Ford Taurus John Smith Peggy Smith VIN 1FAFP34PSRMT7ES010 License No ASD123 Along with this letter you will find enclosed the Retired Vehicle Transfer Manifest form the replacement vehicle requirements insert and a list of approved participating cealerships You must present this approval letter at a dealership on the participating dealerships list included with your voucher The participant s will be responsible for any costs incurred prior to receiving this letter as no reimbursements are allowed Along with your approval letter the Retired Vehicle Transfer Manifest form and clear vehicle title drive Ihe approved retired vehicle listed on this letter to a participating dealership Your approved vehicle will be left with the dealership and the appropriate voucher amount will be applied as the trade in value at the time of purchase You may wish to negotiate a final sales price to ensure you take advantage of all rebates discounts and other incentives being offered by the cealer The participant s named on the approval letter must be the name s on the replacement vehicle title as the voucher is not transferrable Also the approval letter may incluce the names of all adults in your household verified by the Regional Administrator as possible eligible co signers You may be contacted by participating dealers offering their services however you can cho
17. ligible 2011 Vehicles trucks not eligible 2010 vehicles are no longer eligible Database User s Manual Dealer Agreement Instructions Participating Auto gt alvage Dismantlers Dealer Terms and Conditions 1 Dealership representative will need to log into the AirCheck Texas Dealer Database and enter the username and password that was provided Each physical location has its own username and password For example if you have two locations then you will need to log in one location at a time and complete all these steps You have 1 voucher s approved for payment 35 AIRCHECKTEXAS DRIVE A CLEAN MACHINE Dealer Database Follow up Summary User s manual guides dealer through database http www nctcog org trans air act DIrUserManual pdf Dealer must have computer with internet access and credit card terminal to obtain reimbursement Dealer will receive a login user name and password upon signup Dealer logs into database before mailing voucher paperwork to regional administrator Enter Voucher Number into Search for Vouchers link Enter completed dealer checklist fields where prompted in the database Click the Update button and receive Successfully entered message claimed voucher then transfers to Vouchers Pending Payment link Dealer mails or ships all required voucher documents to Regional Administrator Each dealership is responsible for routinely logging in and checking
18. ll liability for personal injury death or property damage Dealership representative must sign and date below to ensure processing Dealer Representative Signature Date Print Dealer Representative Name Print Dealership Name FOR DEALERSHIP USE ONLY 07 28 2015 AIRCHECKTEXAS DRIVE A CLEAN MACHINE Back Dealer Checklist As Drivea NORTH CENTRAL TEXAS REGION AirCheck Texas Clean Machine 6 DEALER CHECKLIST ALL BOXES BELOW MUST BE CLEARLY CHECKED AND VEHICLE INFORMATION COMPLETED BY A PARTICIPATING DEALERSHIP REPRESENTATIVE INCOMPLETE INFORMATION MAY RESULT IN DELAYED PROCESSING CHECKLIST IS NOT INCLUSIVE OF ALL PROGRAM REQUIREMENTS Participant presents valid voucher letter to the dealer representative do not begin negotiations until customer has handed the voucher letter to you and make sure voucher letter has security features and has not expired m Dealer representative must verify that their dealership is a North Texas approved participating dealer Call 817 or visit www nctcog org aircheck cktexas and locate the NCTCOG participating dealership list Agreement form must be completed and returned to the Regional Administrator BEFORE being approved to accept replacement vouchers from program participants Before accepting a voucher from a participant please make sure your dealership is on the participating dealer list The program cannot reimburse non participating dealerships This par
19. o METOCHS ThE ACTA mai 12 17 1611 22 AIRCHECKTEXAS DRIVE A CLEAN MACHINE Retired Vehicle Manifest Summary Complete all information in the Automobile Dealership Section Participant name and address information on this form must match the information showing on the voucher letter lf address changes provide proof of new address If last name changes provide proof of new name Retired vehicle year make model VIN and license plate must match same information on voucher letter Spell out make and model names no abbreviations Participant must sign Dealer contact information must be completed Dealer representative must sign and date Enter all information clearly and correctly so staff can verify the manifest meets requirements and can proceed with document review Inconsistencies or missing information will result in delayed reimbursement 23 AIRCHECKTEXAS DRIVE A CLEAN MACHINE 5 Order John Smith Peggy Smith 9 8 2015 CAR WORLD 175 South Street 1212 First Street Fort Worth TX 76109 Ai am Texas 2T3YFREVOFW168445 Te a gg UE TO TE OELVERES NO LATER TEAM IHELIRARICE COMPANY ALENT PHDHE MOL E8445 9 3 2015 First Insurance 555 555 5 5555 O reu THE BEEN RED i 1573223918 J SUB TOTAL BROUGHT FORWARD BASE PRICE OF VEHICLE ACCESSORIES ANDIOR EQUIPMENT t PRICE OF VEHICLE 2 OTHER TAXABLE CHARGES 3 TOTAL TAXABLE PRI
20. ose from any participating dealers on the list The replacement vehicle being purchased must meet certain criteria please refer to the enclosed insert for important details For a list of eligible Tier 2 Bin 5 or cleaner vehicles meeting the requirements visit www netcog arg alrchecktexas or contact our office to obtain a copy of the list Please visit www nctcog arg airchecktexas or call 1 800 898 9103 if you have any questions regarding the vehicle retirement replacement procedure Thank you AirCheckTexas Program Regional Administrator n MIS ARIA SEA gom GENINE SEN DRE SEu FEIAU FOR DEALERSHIP USE ONLY MUST VERIFY DEALER PARTICIPATION BEFORE TAKING VOUCHER Drive a NORTH CENTRAL TEXAS REGION Drive a AirCheck Clean Machine DEALER CHECKLIST ALL BOXES BELOW MUST BE CLEARLY CHECKED AND VEHICLE INFORMATION COMPLETED BY A PARTICIPATING DEALERSHIP REPRESENTATIVE INCOMPLETE INFORMATION MAY RESULT IN DELAYED PROCESSING CHECKLIST 18 NOT INCLUSIVE OF ALL PROGRAM REQUIREMENTS Participant presents valid voucher letter to the dealer representative do not begin negotiations until customer has handed the voucher letter ta you verify the voucher letter has security features and has nat expired Dealer representative must verify that their dealership is a North Texas approved participating dealer Call 817 608 2350 or visit www ncteog org airchecktexas and locate the NCTCOG participating dealership list
21. oved dismantler Dealer representative will need to be onsite to meet and assist Regional Administrator staff Regional Administrator shall notify dealerships verbally and or in writing of any Findings Dealership may be given an opportunity to correct these findings Additional site visits may be required to follow up on these findings 39 AIRCHECKTEXAS DRIVE A CLEAN MACHINE Sign and Submit Participation Agreement Important Steps After Completing Workshop By signing and submitting an agreement dealership agrees to all Terms and Conditions Allow 7 10 business days for processing You will see the Search For Vouchers link on the Main page of the dealer database once your dealership is officially signed up 40 AIRCHECKTEXAS DRIVE A CLEAN MACHINE Contact Information For Dealerships Dealer Line 817 608 2350 Fax 817 695 9292 Email airchecktexas nctcog org Website www nctcog org airchecktexas Address AirCheckTexas Program PO Box 5888 Arlington TX 76005 5888 41
22. red cn store lot Retired vehicle trarsfered to participating dismantler see list at www driveacleanmachine org Keep goldenrod page af manifest and make two copies of white front page after dismantler signs but before they leave with vehicle Login 70 AirCheckTexas database and comp ete data entry before malina all required documents completed desler checklist goldenrod page of manifest photocopy of front page of manifest Buyer s Order Title Application photocapy of participants driver license and passing Vehicle Inspection Report for replacement vehicle Make and keep copies of all documents for dealership records prior to mailing ALL VOUCHER DOCUMENTS MUST BE RETURNED TO AIRCHECKTEXAS OFFICE WITHIN 30 DAYS OF REPLACEMENT VEHICLE SALES DATE Mail to AirCheckTexas Program P O Box 5888 Arlington TX 76005 5888 Overn ghtDelivery Service AirCheckTexas Program 316 Six Flags Drive Centerpoint Two Arlington TX 76011 falls U5 al Ers ed hareby under penalty of perjury that all infermation provided and cortained herein is complete accurate and frue understand hat falsification of this information andfor attachments may resu tih criminal senalties punishable by law acknowledge that information given is subject to verification and or monitaring authorize AirChheckTexas Program representatives to verify information needed to cer ify eligibility and release the Regional Administrator of a
23. s into database and processes credit card information AIRCHECKTEXAS DRIVE A CLEAN MACHINE Vehicle Replacement Voucher Verification Tamper Resistant Paper o Light green color on both sides o Basket weave pattern on both sides E Pros o COPY appears if photocopied Fiscal Year 2016 Voucher Letter Verification Checklist o Unique diamond pattern watermark Ski iau eed uh ld dean 1 Tamper Resistant Paper e Pa rticipant Information Moa he FS desta fth pain aut s o Participant name and address i The hidden message COPY appears on a photocopied page O Eligible co signer s ii une in lower left corner disappears and will reappear o Retired vehicle information b Dealer Checklist Back Side eame as front of page O m Expiration date 2 Participant Information all participant information name s address eligible co signer s retired vehicle information voucher number and expiration date 15 automatically printed on the voucher letter Letter Heading Letter Heading North Central T Region i d by the North Central T Council of O 5 u ed by N CTC Q fo rnin e N rt h i intense for Collin Dallas Denton Ellis eidem Kausa Parker Rockwall and Tarrant counties Ce n I ra u nt I es b Voucher No used to uniquely identify the voucher and participant used by dealer to claim in the AirCheckTexas database O Vo u
24. ship Requirements Procedures Terms and Conditions Send at least one dealer representative to a dealer workshop for program training or complete other designated training Sign and submit a Dealer Participation Agreement outlining the program rules and regulations to which every dealer will be subjected AIRCHECKTEXAS DRIVE A CLEAN MACHINE Participation Requirements Continued Maintain at least two valid email addresses Attend all mandatory workshops as required by Regional Administrator Sell vehicles that meet the requirements listed in Section 5 2 of the Terms and Conditions Maintain Internet access to the AirCheckTexas Dealer database and for the public to access the Drive a Clean Machine Website Maintain credit card transaction processing capabilities with the ability to enter credit card number and expiration date into a terminal AIRCHECKTEXAS DRIVE A CLEAN MACHINE Major Steps in the Process Participant applies to NCTCOG for replacement voucher Approved participant receives voucher letter amp manifest in the mail Dealer starts checklist process after participant presents voucher Dealer determines vehicle eligibility and completes sale Dismantler picks up retired vehicle and completes manifest Dealer completes checklist and enters information in database Dealer mails or ships voucher documents to AirCheckTexas Staff reviews documents for payment within ten 10 business days Dealer log
25. t is not limited to the following exhaust gas recirculation system power control module catalytic converter oxygen sensors evaporative purge canister positive crankcase ventilation valve gas cap SEE PENALTY NOTICE ON REVERSE SIDE mercury switches have been removed and also certify that the vehicle has been destroyed and the remaining residual scrap metal will be conveyed to a participating recycling facility Dismanter Representative Verifying Deetruction of Equipment and Vehicle RecycunG Faciurrv Recewine Reswuar Scrap METAL SEE INSTRUCTIONS ON REVERSE SIDE Recycling Facility _ 0 Phone Ll County Physical Address Oli ii Zip Print Name Rocyclng Representative Receiving Residual Scrap Metal White Automobile Dealership Green Automobile Dealership Yellow Salvage Dismantling Facility Pink Er oq Facility Goldenrod Auto Dealership tio NCTCOG so to fie to fio o TROT INGTON Rew 12 17 14 20 AIRCHECKTEXAS DRIVE A CLEAN MACHINE AirCheckTexas Retired Vehicle Transfer Manifest AinCueckTexas RETIRED Venice TRANSFER 41 1121 943 Program Administrator NORTH CENTRAL TEXAS COUNCIL OF GOVERNMENTS NCTGOG Phone Toll Free P O 5888 ARLINGTON TEXAS 76005 5888 817 608 2350 AUTOMOBILE DEALERSHIP SECTION Tc be filled aut by Doalersh ig VEHICL
26. the Fair Market Value Deduction V amp 8 Tax Codo 5152 002 GON or Lessor Number Trade in f any Vehicle dentcatian Mumker Year Make 32 Additional Trade ina 1FAFP34P5RM789010 _ 1990 Taurus AIRCHECKTEXAS DRIVE A CLEAN MACHINE 30 AIRCHECKTEXAS DRIVE A CLEAN MACHINE Title Application 33 SALES AMD USE TAX COMPUTATION a Sales Prce 2000 00 rebota has been deducted s 20 101 85 New Resident Tax Previous State b Less Trade in Amount described in Item 31 above t 3 000 mmm 55 Even Trade in For Dealers Lessors Rerial ONLY Fair Market Value m C 319 Git Tax Use Comptroller Form 14 317 Deducbon described in hem 31 above s 55 Rebuill Salvage Fez 4 Taxable Amount Hem a minus Item b Item 5 17 101 85 25 Emissions Fee Diesel Vehiches 1996 and Cider gt 14 000 Ibs 8 6 25 Tax on Taxable Amoura Multiply d by 0825 1 068 87 1 Emissions Fee Diesel Vahidas 1997 and Newer gt 14 100 Is f Late Tax Payment Penany _ 5 er _ 10 7 Exemption elsimed under the Motor Vehicle Sales and Use Tax Law Because a Tax Paid to STATE 5 0 00 ih AMOUNT OF TAX AND DUE PT 228 or 23 Apc Be EL Teun Tala em e plus been T nap Item gi 1 068 87 Contact your county tax assessor collector for the correct fee 1 Hereby Cor
27. ticipation list will change year to year AIRCHECKTEXAS DRIVE A CLEAN MACHINE Back Dealer Checklist FOR DEALERSHIP USE ONLY MUST VERIFY DEALER PARTICIPATION BEFORE TAKING VOUCHER AlChecklexas o ALL BOXES BELOW MUST BE CLEARLY CHECKED AND VEHICLE INFORMATION COMPLETED BY A PARTICIPATING DEALERSHIP REPRESENTATIVE INCOMPLETE INFORMATION MAY RESULT IN DELAYED PROCESSING CHECKLIST 18 NOT INCLUSIVE OF ALL PROGRAM REQUIREMENTS ii Participant presents valid voucher letter to the dealer representative do not begin negotiations until customer has handed the voucher letter to you verify the voucher letter has security features and has not expired Dealer representative must verify that their dealership is a North Texas approved participating dealer Call 817 608 2350 or visit www nctcog org airchecktexas and locate the NCTCOG participating dealership list Buyer is the same person s as the Participant Name s printed on the voucher letter If needed ensure co signer s name appears in the Eligible Co signer s printed the voucher letter Trade in vehicle is drivable and matches Retired Vehicle Information printed on voucher letter 1 Record all details of REPLACEMENT vehicle being purchased below before it is sold Obtain information from vehicle liters Underhood ID Test Group DER mill Vehicle qualifies for program compare details
28. tity That All Statements In This Document Are True And Correct To The Best Of My Knowledge And Bellet __ Jane Jones 09 03 2015 Printed Name Same a5 Signature Date Printed Namejs Same as Signature s Date John Smith 0903 2015 Printed Same as Signature Date Peggy Smith gt 10910312015 DER EP T ional Owners Printed Name s Same as Signatureis Date WARNING Transportation Code 8501 155 provides that falsifylng information on title transfer documents third degree any s Form 130 U Rev 02 2015 Online Form at www TxDMV gov 31 AIRCHECKTEXAS DRIVE A CLEAN MACHINE Title Application Summary Participant name and address information on this form must match same information on voucher letter lf address changes provide proof of new address last name changes provide proof of new Replacement vehicle being purchased year make model VIN must match same information on dealer checklist Voucher amount 3 000 or 3 500 listed as trade in sales tax calculations will be checked Vehicle sales price must meet program guidelines Purchase date must be within voucher issued date and expiration date dates shown before voucher issued or after expiration date will NOT be reimbursed Participant and dealer must sign and date Enter all information correctly so staff can verify the vehicle meets reguirements and proceed with
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