vtp5 application form - notification of an alteration … · 2021. 1. 29. · vtp5 (dvsa 522) 1...

VTP5 (DVSA 522) 1 v3.5 January 2021

NOTIFICATION OF AN ALTERATION TO A PUBLIC SERVICE VEHICLE

VTP5 Public Passenger Vehicles Act 1981

Please read all the Notes

as you complete this form. FAILURE TO COMPLETE THE FORM ACCURATELY OR IN FULL COULD RESULT IN

DELAYS OR

REJECTION

1a. OWNER / APPLICANT CONTACT DETAILS

Title : Name :

Company Name : (If applicable)

Address :

Post code : Tel. No. :

Email Address :

1b. PRESENTER DETAILS (If different from owner)

Title : Name :


Address :

Postcode : Tel. No. :

2. TEST STATION DETAILS

Which test location would you prefer? :

Please Note : Examinations are normally conducted at DVSA test locations. Please allow 3 clear weeks for your application to be processed. If you do not hear from us within this time,

please contact our Customer Contact Centre on 0300 123 9000.

3. VEHICLE DETAILS

Reg. Mark :

Full Chassis (VIN) No. :

Make Model Month / Year of Manufacture

Chassis

/

Body /

https://www.gov.uk/government/publications/specialist-schemes-testing-station-map


VTP5 3. VEHICLE DETAILS (Cont...)

External Dimensions (cm) ▼

Maximum Length Maximum Height Wheelbase

A single Notification can be used for up to 10 vehicles, providing the vehicles and the alteration are of identical technical specification and the vehicles are to be inspected in the same geographical area.

Is this Notification for more than one vehicle?

YES NO If YES, please complete the Annex to this application on page 4.

4. DETAILS OF NOTIFIABLE ALTERATION

Please Note : Details of notifiable alterations to a PSV are subject to the requirements of Section 20 of the Public Passenger Vehicles Act 1981 as amended by Section 29 of the Transport Act 1985. If you make any alteration to the specification of a Public Service Vehicle, you are required to notify us. Normal replacement of worn, defective or damaged parts, or components on a like for like basis and the fitment of emissions abatement devices are not notifiable. Please give details of all the alterations (including consequential alterations) that have been made to the vehicle below. DVSA may refuse to examine your vehicle, or request it is returned for further examination if all the alterations are not disclosed. ▼

5. STANDARD TO BE APPLIED ON RE-APPROVAL

If the vehicle has been subject to an alteration of a ‘body related’ item e.g. seating or standing capacity, exits, internal modification etc; is it now :

a.

Considered compliant with the technical standards as applied at

YES NOthe time of original certification (e.g. ECR Reg.107.02, Reg.36, Reg.52 Directive 2001/85, COIF or C & U requirements)?

b. Considered compliant with the required standards of item 52, Part

YES NO

4 of Schedule 2 of the Road Vehicles (Approval) Regulations 2020

(IVA)? Please Note : This criteria (b) is only accepted as an alternative in respect of a vehicle original approved to Reg.107.02, Reg.36, Reg.52 or EC Directive 2001/85. For more inform

ation on the standards applicable, go to www.gov.uk/dvsa.

https://www.gov.uk/government/publications/guide-to-notifiable-alterations-to-a-psv


VTP5 6. CHANGES TO CARRYING CAPACITY

Where the alteration changes the carrying capacity, please provide the following details :

Before Alteration

After Alteration• Upper Deck Capacity

• Lower Deck Capacity

• Standing Passengers

• Wheelchair Positions

• Crew Seats Fitted

7.

Where an item has been added to the vehicle or the carrying capacity has increased,please indicate which of the following items are fitted :

Air Conditioning

YES NO If YES, please give the location below ▼

Alloy Wheels YES NO Entertainment Monitor / Screen YES NO

Double Glazing YES NO Wheelchair Lift or Ramp

YES NO

8. TYPE OF SUSPENSION

Please provide the type of suspension fitted to each axle e.g. air, leaf etc :

Axle 1

Axle 2 Axle 3 Axle 4

9. VEHICLE UNLADEN WEIGHT

Has the unladen weight changed as a result of the alteration? :

YES NO If ‘YES’ please provide the new weight :

kg

Please Note : Evidence must be provided at the time of inspection.

VTP5 (DVSA 522) 4 v3.5 January 2021 Jan

VTP5

10.

EXAMINATION REQUIREMENTS

This item applies to all vehicles selected for examination including those listed on Annex VTP5A These vehicles require cleansing/quarantine prior to examination.

a) Conditions that apply at the time of examination:

• arrive at least 20 minutes prior to appointment time • only one person to attend with the vehicle • open all apertures including doors, lockers, glove box, boots, bonnets windows and

load areas together with switching on any forced air ventilation • inform our Examiner of your presence (observing social distancing rules) • be prepared to move your vehicle onto pit/hoist if requested - Note - at this point the

examiner may check some items i.e. Lights, brake operation etc. with you in the vehicle

• ensure our Examiner has contact details if different from those on the application form.

• leave the site during some of the examination - Note - you will be informed when to return

• on completion of the examination, the vehicle will be parked in a safe area away from the test lane

• upon collection, consider the benefit of venting the vehicle with all doors and windows open before driving away

b) Conditions that apply prior to examination.

In accordance with government advice, prior to examination and to minimise the risk of COVID 19 infection you need to confirm that the vehicle(s) listed on this application comply with the following:

• that the vehicle (and including any listed on Annex VTP 5A) has been constructed or modified in compliance with all current COVID-19 Government and industry sector guidelines and, either;

• all vehicle surfaces have been or will be thoroughly and virally cleaned immediately before the examination following current COVID-19 Government and industry sector guidelines, or

• the vehicle has been or will be securely quarantined for at least 72 hours immediately before the scheduled examination appointment.

You must sign the declaration below confirming that these conditions will be met at the time the vehicle is presented for examination. Note - At the time of examination the presenter must follow all directions given by the examiner. The presenter should wear appropriate PPE and maintain social distancing when not in control of the vehicle. The examiner will refuse to test the vehicle if these conditions are not met.


VTP5 11. DATA PROTECTION, DECLARATION & SIGNATURE

DATA PROTECTION – The personal information you provide on this form will be used for the purposes of DVSA’s statutory functions. It will not be disclosed to other organisations unless required or permitted by law. For further information, visit the Personal Information Charter available from www.gov.uk/dvsa. DECLARATION – I the undersigned declare that:

• the vehicle listed above (and including any listed on Annex VTP 5A) will be built inaccordance with the required standards contained in the relevant COIF/DDARegulations

• the conditions listed at item 10 will be met in respect of any vehicle listed at the timeappointed for the examination

• as far as I know, all statements in this application are true.

Signature : Date : / /

Print Full Name :

Please Note : All ‘Declaration’ sections above must be completed. A typed ‘Signature’ is acceptable if sending your form electronically.

ON COMPLETION

Please attach your fully completed application to the ‘Technical Application System’ (TAS) available on : www.gov.uk/dvsa

Should you experience problems accessing TAS, please try an alternative browser.

DVSA Customer Contact Centre : 0300 123 9000

VTP 5A Annex Continued Overleaf ►

https://www.gov.uk/apply-vehicle-test-certificate-coach-bushttps://www.gov.uk/government/organisations/driver-and-vehicle-standards-agency/about/personal-information-charter


NOTIFICATION OF AN ALTERATION TO A PUBLIC SERVICE VEHICLE

VTP 5A ANNEX

Public Passenger Vehicles Act 1981

OWNER / APPLICANT DETAILS

Title :

Name :


VEHICLE 2

Reg. Mark :


VEHICLE 3

Reg. Mark :


VEHICLE 4

Reg. Mark :


VEHICLE 5

Reg. Mark :


VEHICLE 6

Reg. Mark :


VEHICLE 7

Reg. Mark :


VEHICLE 8

Reg. Mark :


VEHICLE 9

Reg. Mark :


VEHICLE 10

Reg. Mark :


Company Name: Address: Post code: Tel No: Email Address: Company Name_2: Tel No_2: Which test location would you prefer: Maximum Height: Wheelbase: Axle 1: Axle 2: Name_3: Company Name_3: Address 2: Title: []Postcode 2: Reg Mark: Chassis Vin: ChassisMake: ChassisModel: ChassisMonth: BodyMonth: ChassisYear: BodyMake: BodyModel: BodyYear: Max length: More vehicles: Offnotifiable alterations: Original: OffItem 52: OffUpper Before: Upper After: Lower Before: Lower After: Standing Before: Standing After: WC Before: WC After: Crew Before: Crew After: AC: OffAlloys: OffScreen: OffGlazing: OffRamp: OffAxle 3: Axle 4: Unladen: OffWeight: Signature: Print Name: Year: Month: Date: Title 2: []Title 3: []Reg Vehicle 3: Reg Vehicle 4: Reg Vehicle 5: Reg Vehicle 6: Reg Vehicle 7: Reg Vehicle 8: Reg Vehicle 9: Reg Vehicle 2: Reg Vehicle 10: VIN Vehicle 4: VIN Vehicle 3: VIN Vehicle 5: VIN Vehicle 6: VIN Vehicle 7: VIN Vehicle 8: VIN Vehicle 9: VIN Vehicle 2: VIN Vehicle 10: Test Locations URL: Comp Address 1: Comp Address 2: Applicant Name: Presenter Name: Not Alt URL: Personal Info URL: Air Con Location:

vtp5 application form - notification of an alteration … · 2021. 1. 29. · vtp5 (dvsa 522) 1...

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