AUTORIZAO PRVIA PARA MODIFICAO DO VECULO

Eu,_______________________________________________________________________________, portador do
RG__________________________,

CPF_______________________,

residente

na

___________________________________________________________________, n___________, complemento

___________________ bairro _____________________________, CEP_________________________
DADOS DO VECULO:
PLACA ________________________, CHASSI ___________________________________________________
ESPCIE/TIPO _________________________________ COMBUSTVEL ______________________________
MARCA/MODELO __________________________________________________________________________
ANO DE FABRICAO _____________________________, ANO MODELO _________________________.
Venho solicitar, Conforme Lei n 9503 de 23/09/97, Art. 98 e Resoluo CONTRAN n 292-98, Autorizao para
realizar ou ordenar que sejam feitas no veculo as seguintes modificaes de suas caractersticas de fbrica:
De:____________________________________________________________________________________
Para:_________________________________________________________________ _____________

________________, ______ de _________________________de 20___________.

__________________________________________________
(assinatura solicitante)
-------------------------------------------------------------------------------------------------------------------

AUTORIZAO PRVIA PARA MODIFICAO DO VECULO

PLACA: __________________________DATA: ________/______________/_______
NOME: ____________________________________CPF:_____________________________
SOLICITAO DEFERIDA
SOLICITAO INDEFERIDA. MOTIVO: _____________________________________________
______________________________________________________________________________.

________________, ______ de _________________________ de 20___________.

_____________________________
(Assinatura Responsvel DETRAN-SP)