Historic Registration Application Form

Name:

Phone No:

Email:

Address:

Date:

Membership No:

Membership Year:

* Please inform LPOC NSW of your Historic Plate number once obtained

VEHIICLE DETAILS

Make:

Model:

Trim Level.:

Year:

Colour:

Chassis No:

Engine No:

Historic Plate No:

Pink Slip No:

Registration Expiry Date:

All submissions for Leyland P76 Owners Club NSW Inc (LPOC NSW) Historic Registration must be accompanied by
detailed photographs of the above said vehicle to assist the LPOC NSW Historic Registration Registrar to evaluate eligibility for historic registration. Any changes to the vehicle made after it's approval and / or modifications not divulged at the time of application may render the historic registration for the vehicle null and void

LPOC NSW can request the vehicle be presented for inspection at any time and the vehicle must attend at least two sanctioned club events in the club calendar year.

Vehicle modifications

The Club also requires compliance with the rule stating that the vehicle be as close to standard/original as
possible but with acceptable variations of period style options and accessories being added to the vehicle as
they may have been during the vehicle's era. Please list any modifications:

Vehicle use

Vehicles can only be used for events organised by their Club, another Club or recognised community organisations provided an official invitation has been received and documented by the Club in the official minutes, or the official Calender .Vehicles can also be used on a road or road related area for:

• Servicing within a short distance from their place of garaging

• The inspection of the vehicle.

If a longer journey is necessary, the member must notify the Club Registrar so that they can enter the details in the Club's official Calender, Day book or minutes.

I have read and understand all terms and conditions for Leyland P76 Owners Club NSW Inc Historic Registration and declare the above said vehicle meets the requirements of the LPOC NSW Historic Registration guidelines.

(this form is to be filled out and sent to the club registrar annually one form per vehicle)

Signature:

Date: