/ OFFICE USE ONLY / MotorSport NZ Inc
PO Box 3793, Wellington 6015
Ph: 04 815 8015
Fax: 04 472 9011
Email:
GST NUMBER: 10-062-349
Date Received:
Date Approved:
Logbook Number:
Replacement Number:

Applicants Name:

*NOTE: Previous Logbook must accompany application for Renewal- Previous Logbook will be returned

*NOTE: If selecting a Priority Payment option please include physical address for courier- Not PO Box

Payment Details- Fee’s Effective as of 01 Oct 2014

PAYMENT BY CREDIT CARD: Please debit my VISA / MASTERCARD
Card No / - / - / - / Expires
Name of Card Holder
Signed / Date
¨ Standard Processing: $30.00 / ¨ Priority Processing + $15.00 ($45.00 total)
Payments can be made by Internet Banking to ASB Bank 12-3192-0017344-00
Please reference Name and Application Type
Cheque Payments can be made out to MotorSport New Zealand
IMPORTANT INFORMATION ABOUT THIS APPLICATION

**ALL APPLICANTS MUST READ THIS IMPORTANT IMFORMATION AND MUST FOLLOW THE REQUIREMENTS OF THIS APPLICATION OR IT MAY BE RETURNED AND AN ADDITIONAL 50% OF THE ORIGINAL FEE CHARGED**

Logbook Type:

·  NATIONAL logbook covers ALL MotorSport NZ permitted events (including ClubSport)

·  RENEWAL Option is only available if the previous logbook is provided (which will be returned with new logbook). If logbook is lost or damaged then a new application is applicable.

Owners Details:

·  Current vehicle owners name required (only ONE please)

·  Full name of Owner, Date of Birth and Email Address are Mandatory fields

·  Please be sure to include your correct post code

Vehicle Details:

·  Make (Ford, Holden, Fiat, etc.)

·  Model (Falcon, Kingswood, Bambina, etc.)

·  Body- Refer current MotorSport Manual for definitions if required

·  Chassis: All vehicles must have a unique identification number permanently stamped or inscribed into the bodyshell/chassis of the vehicle. Please use the manufacturers’ Chassis No. (not NZ VIN)

·  Engine (cc): being the actual engine displacement in cubic centimetres before any correction factor is applied (Conversion: Cubic Inches x 16.4 = Cubic Centimetres)

·  Engine type: being the engine operating principle. A correction factor of 1.8 will be applied to rotary engines and 1.7 to all forced induction engines. Leave blank if neither apply.

·  MSNZ Safety Cage/Rollbar Homologation Number: This is typically a 4 digit number preceded by ‘NZ’ or ‘TC’ or “NZTA”. This only applies if the vehicle has previously had the Safety Cage/Rollbar homologated by MSNZ

Note: If you have a Safety Cage/Safety Rollbar which has yet to be Homologated/Approved the appropriate application form MUST accompany this Vehicle Logbook Application.

Vehicle Schedule/Class:

·  This section refers to the safety schedule which the vehicle will compete under. NOTE: 95% of vehicles will compete under Schedule A.

New Vehicle Owner:

NOTE: If you have purchased a motorsport vehicle which already has a MSNZ Vehicle Logbook then just complete the “Record of Ownership” with your current details. Only use this form if there is no logbook provided by the seller with the vehicle.

VEHICLE LOGBOOK APPLICATION

Technical Form - T001

□ New Logbook □ Logbook Full (send with application) □ Logbook Lost (please tick one)

PRESENT OWNERSHIP DETAILS

Name of Owner:
Date of Birth: / MSNZ Licence:
Postal Address:
Suburb/Town: / Post Code:
Home Phone: / Work phone:
Email Address:

VEHICLE DETAILS

Make: / Engine: / 4-Stroke / 2-Stroke / Rotary / Electric (Circle One)
Model: / Normally Aspirated / Turbo / Supercharged (Circle One)
Year: / Displacement: / cc / (uncorrected)
Registration No: / (Only required if road registered)
Body Style: Saloon, Sports Car, Ute / Single Seater / Sports Racing Car / Truck: (Circle One)
Manufacturer Chassis Number (not NZ VIN)
MSNZ Safety Cage/Rollbar Homologation No: / (Only applicable if already Homologated)

VEHICLE SAFETY SCHEDULE

General Competition Use
o Schedule A (applies to all vehicles not specifically listed below)
Classic & Historic
o Schedule AA / Certificate of Description No.:
(The vehicle must have a Certificate of Description to run under Schedule AA)
Other
o Please Specify

T001 Vehicle Logbook Form Application Page 1 of 1

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