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General Information

Municipality:

Population:

Street address:

Zip Code:

Average number of vehicles registered annually:

Do you have a municipal web site?: Select Yes No

If yes, what is the web address (URL):

Do you receive inquiries from your citizens about online registration?: Select Yes No

If yes, how often?: Select Daily Weekly Monthly

Do you use electronic registration software?: Select Yes No

If yes, indicate your e-reg vendor: Select Gemini Northern Data Trio Network Systems

Municipal Contact Information

Municipal Contact Person:

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Contact Phone:

Contact Email:

Municipal Official Information

Name of municipal official with contracting authority:

Title:

Your Information

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Title:

 

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