MSVA 1 / DVSA 0234

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V5.0 Mar 2021

Motorcycle Single Vehicle Approval

APPLICATION FOR A MINSTER’S APPROVAL CERTIFICATE

(MSVA 1)

Motor Cycles etc. (Single Vehicle Approval) Regulations 2003

Please refer to the MSVA Guidance Notes before completing your application. Failure to complete the form accurately or in full could result in delays or rejection.

Section 1 – Applicant Details

Name

Company Name (if applicable)

Address (including postcode)

Telephone Number

Email Address

Section 2 – Test Details 2a. Which test location would you prefer? (Refer to the MSVA Guidance Notes)

1st Choice 2nd Choice

Section 3 – Vehicle Details 3a. Vehicle Identification Number (VIN) (Refer to the MSVA Guidance Notes)

3b. Vehicle make and model

Make Model

3c. Vehicle Type – Please tick appropriately (Refer to the MSVA Guidance Notes)

Moped Low Powered Moped

Motor Tricycle

Heavy Quadricycle

Motorcycle Motorcycle & Sidecar

Light Quadricycle

M

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Section 3 – Vehicle Details (cont.) MSVA 1

3d. Is the vehicle designed to carry goods? Yes No

3e. Number of wheels (Moped only) Two Three

3f. Which side of the vehicle is the sidecar on? (Motorcycle and Sidecar only) Right Left

3g. Vehicle category

Please refer to the MSVA Guidance Notes for definitions. If none applies, please leave blank.

Amateur Built Rebuilt Vehicle manufactured using parts of a registered vehicle

3h. Is the vehicle built from a kit? Yes No

3j. Is it a special/custom vehicle built from the ground up? Yes No

3k. Does the vehicle have full bodywork? Yes No A bodied vehicle is defined as ‘a vehicle with a structure consisting/comprising of a floor plan and panels, which with a roof, fully encloses the vehicle occupants and without a roof, encloses them other than where the roof would be’.

3m. Date of manufacture (month and year)

This information should be obtainable from the manufacturer’s data plate, the owner’s manual or from the manufacturer of their agent.

3n. Date of manufacture of the engine

Only required for vehicles which fall into categories listed under 3g above.

3p. Engine details

Petrol 2 stroke Turbocharged Non-Turbocharged

Diesel Petrol 4 Stroke Other e.g. LPG, electric

3q. Transmission type Manual Automatic

3r. Engine capacity (cc) Fuel tank capacity (litres)

3s. Engine/motor maximum power output bhp PS kW

3t. Maximum power engine speed (rpm)

Maximum road speed (mph)

M

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Section 3 – Vehicle Details (cont.) MSVA 1

3u. Vehicle weights (kgs)

Unladen weight Goods vehicle payload

3v. Gross design weights (kgs) Only required for goods vehicles.

Axle 1 Axle 2 Axle 3 Gross Train

This information should be obtainable from the manufacturer’s data plate, the owner’s manual or from the manufacturer or their agent. If the vehicle is powered by an electric motor, these weights should not include the weight of the batteries.

3w. Weight of batteries (kg)

The weight of batteries is required for electrically propelled vehicles only.

3x. Is the vehicle fitted with an anti-lock brake system? Yes No

3y. Is the vehicle fitted with a linked braking system? Yes No

Section 4 Annex Covid - 19 – Declaration of Compliance

When your application for an MSVA and this declaration have both been processed (please allow a few days) an appointment can be requested by contacting 0300 123 9000.

Due to the impact of the pandemic DVSA may not be able to offer the level of service previously experienced. We will however try to offer you an appointment as soon as possible.

Please read all guidance notes and complete all questions. Failure to comply will result in rejection of your application.

a) Conditions that apply at the time of examination:• arrive at least 20 minutes prior to appointment time.• (if applicable), to open all apertures including doors, lockers, glove box, boots,

bonnets windows and load areas together with switching on any forced airventilation and fasten all seat belts.

• inform our Examiner of your presence (observing social distancing rules)• To 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/onthe vehicle.

• ensure our Examiner has contact details if different from completed PT1 form• on completion of the examination, the vehicle will be parked in a safe area away

from the test lane.• upon collection, (if applicable) you should consider the benefit of venting the vehicle

with all doors and windows open before driving away

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Section 4 Annex Covid - 19 – Declaration of Compliance (cont.) MSVA1

b) Special conditions prior to the 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 listed on this application comply with the following:

• that the vehicle has been constructed or modified in compliance with all currentCOVID-19 Government and industry sector guidelines and, either:

• all vehicle surfaces have been or will be thoroughly and virally cleaned immediatelybefore the examination following current COVID-19 Government and industrysector guidelines, or

• the vehicle has been or will be securely quarantined for at least 72 hoursimmediately before the scheduled MSVA examination event.

You must sign the declaration below confirming that these conditions have been met.

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.

Section 5 – Data Protection, Declaration and Signature

We collect, use and store your personal data so that we can correctly process your MSVA 1 (Motorcycle Single Vehicle Approval) application form.

We may share your personal data if we have a lawful reason. For example, as part of a criminal investigation or to prevent fraud. Find out more at www.gov.uk/dvsa/privacy. Declaration: I the undersigned declare that:

• the vehicle listed above will be built in accordance with the required standardscontained in the relevant MSVA Inspection Manual and/or Technical Standards.

• the conditions listed at Section 4 item “b)” above will be met at the time appointedfor the examination.

I confirm that, to the best of my knowledge, all statements in this application are true.

Signature :

Print Name :

Date :

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V5.0 Mar 2021

Section 6 – Payment Details MSVA 1

You can pay the application fee by one of the following methods :

1. Cheques/Postal Orders – payable to the ‘Driver and Vehicle Standards Agency’ (DVSA). Only accepted with postal applications.

2. Credit/Debit card – If you choose to pay by this method, then once your application has been received, you will be contacted by email with instructions on how to arrange your card payment.

3. Pre-Funded Account – If you are a regular user of the scheme, this is the quickest method to use. For pre-funded accounts, the signatory on the application must be a delegate authorised to use the account. For more information on setting up a pre-funded account, go to www.gov.uk/dvsa.

MSVA Refund Policy - Please refer to the MSVA Guidance Notes (Section 6) for further details.

How are you paying for this application? (Please tick one box)

Cheque / Postal Order Payable to ‘Driver and Vehicle Standards Agency’ or ‘DVSA’ (only with postal applications).

Credit / Debit Card Payment to be made after application is received.

DVSA Pre-funded Account PFA Number :

I hereby authorise the Driver and Vehicle Standards Agency to take the amount stated from my bank / pre-funded account in respect of my application ►

£ .

Signature Details : Please sign and print your name if you are either the card holder or PFA delegate. If sending your form electronically, a typed ‘Signature’ is acceptable.

Signature :

Print Full Name :

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 web browser. For further information, please email enquiries@dvsa.gov.uk or telephone the

DVSA Customer Service Centre – 0300 123 9000.